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The article presents the results of experimental research on monofilament suture with different biodegradation periods when implanted into trachea tissue. The data obtained via histological, morphological and morphometric methods have been shown that application of monofilament suture material with long biodegradation period causes evident inflammatory reaction of trachea tissue, which persists through the entire period of monitoring, by 30th day the cell index value is 0.4±0.05. Unlike monofilament non-absorbable suture and suture with short biodegradation period, the application of which is marked with active proliferative process on the 14th day, the cell index is equal to 0,9±0.05 and 1,1±0,06 respectively. The obtained data demonstrate that application of monofilament suture material with long-term biodegradation period in tracheal surgery is non-desirable as the inflammatory process maintained by the suture material under conditions of high contamination by bacteria and active process of mucus formation will adversely affect healing. Application of suture with short-term biodegradation period in acute trachea injury treatment is optimal due to the fact that the organ tissue shows minimal reaction to suture and 60 days later the suture is completely absorbed, that means will not cause further complications.

Background. Combination of gemcitabine, metronomic capecitabine and mitotane (GemCap + m) is the most studied regimen in second and subsequent lines of therapy for advanced adrenocortical cancer (ACC). Previously published studies do not give a definitive answer to the question- what plays a key role in realizing the response to treatment: chemotherapy or mitotane in therapeutic concentration.Aim. Evaluation the efficacy and safety of GemCap + m combination with the standard dosing regimen of capecitabine in patients with metastatic ACC.Materials and methods. This retrospective single-center clinical study included patients over 18 years of age with histologically confirmed ACC with disease progression after completion of platinum-containing therapy. They received chemotherapy regimen gemcitabine 800 mg/m2 for days 1, 8 and capecitabine 1000 mg/m2 orally 2 times at days 1–14 of the 21-day cycle with mitotane. we evaluated objective response, stabilization of disease, 6-months disease control rate and median progression-free and overall survival. Radiological assessment according to RECIST 1.1 criteria was carried out every 6–8 weeks of treatment.Results. The study included 25 patients. mitotane concentration above 14 ng/mL was achieved in 22 (88 %) patients, of which 21 (84 %) reached therapeutic concentration in previous treatment lines. 80 % of patients received treatment as 2nd line, 20 % as 3rd and subsequent lines. The objective responses and disease stabilization was observed in 1 (4 %) and 11 (44 %) of patients, respectively. Disease control for at least 6 months rate was 24 %. median progression-free and overall survival were 3.2 months and 12.17 months, respectively. Toxicity grade 3–4 was observed in 28 % of patients. gemcitabine dose reductions due to thrombocytopenia grade 1–2 were required in 2 cases (8 %), no capecitabine reductions were necessary.Conclusion. This study demonstrates the effectiveness of a new dose regimen of chemotherapy GemCap + m in the second and subsequent lines of therapy for metastatic ACC. The progression of the disease against the background of previous lines of therapy at a therapeutic concentration of mitotane in the majority of patients indicates the effectiveness of the chemotherapeutic component of gemCap in a cohort of patients resistant to platinum and mitotane.