The study is devoted to the peculiarities of surgical treatment of Zenker diverticulum. For convenience and for safety we propose the use of intraoperative video endoscopic transillumination of the diverticulum. The method significantly increases the safety of operation, shortens its duration and results to a better cosmetic effect. To avoid relapse, diverticulectomy should be supplemented by cricopharyngeal myotomy.

Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий1, Ореховый бульвар, д. 28, Москва, 115682, Российская Федерация Московский государственный медико-стоматологический университет им. А.И. Евдокимова2, ул. Делегатская, д. 20

Aim. To assess overall survival and recurrence-free period in patients with locally advanced pancreatic cancer who underwent irreversible electroporation of the tumor in combination with chemotherapy. Matherials and methods. It was performed a prospective analysis of overall survival in 23 patients who underwent irreversible electroporation of unresectable pancreatic cancer for the period from May 2012 to March 2017. Control group consisted of 35 patients with pancreatic cancer stage III who received standard chemotherapy alone. Results. Mean age of patients was 61 years (range 45–80). All procedures were successful. Fifteen patients had pancreatic head cancer, 8 – cancer of pancreatic body. Preoperative chemotherapy has been applied in 20 (86.9%) patients for 4 months prior to surgery on the average. Seventeen (73%) patients underwent chemotherapy after electroporation procedure. 90-day mortality was 4.3% (n = 1) in electroporation group. Surgery was followed by improved local recurrence-free survival (12 and 6 months, respectively, p = 0.01) and distant recurrence-free survival (15 and 8 months, respectively, p = 0.03). Overall survival was 18 and 11 months, respectively (p = 0.03). Conclusion. Irreversible electroporation of locally advanced pancreatic cancer is safe. Four-month chemotherapy followed by surgical procedure is associated with good local response and better overall survival compared with chemotherapy alone. These data will be validated in further multicenter study.

Introduction: Advanced cases of carcinomas with parametrial and fornix infiltration often cause massive genital bleeding, with severe anemia, fast deterioration, and a high risk of death for patients. One method of stoped bleeding is transarterial chemoembolization, which has been studied. Methods: Seven women with advanced uterine and cervix cancer or the pelvic locoregional recurrence withgenital massive bleeding were treated using an endovascular therapy (transarterial chemoembolization (TACE) using cisplatin or doxorubicin or gemcitabine). Ware used HepaSphere (Bioshere Medical, France) filled with saturated 50 mg doxorubicin or 500 mg gemcitabine or 50 mg cisplatin. Results: On average, the total operative time for the procedure was 52 minutes. In all cases, the achieved control bleeding. By the 7th day were signs of reduction in tumor size, 1/3 of its original size. The maximum effect on the tumor size was achieved within 14-20 days. In 2 cases, chemoembolization performed twice at an interval of 21 to 28 days, due to a good picture of the ultrasound tumor vascularization. All operations are carried out under the I/V anesthesia and we had no adverse reactions or complications. Conclusions: Arterial chemoembolization dominant vessels tumor is a reliable method of stopping the genital bleeding at any time during of the planned treatment. It is to improve the quality of life of patients. Antitumor efficacy of drug has a lasting effect. The method is applicable as a minimally invasive, effective for treatment of cancer patients.

Tumors of the myometrium, reminiscent of leiomyoma with atypical location and aggressive growth, represent a diagnostic problem due to their common manifestations in various imaging techniques. These include various types of uterine leiomyomas, stromal endometrial tumors and rare tumors of cahal-like cells.