No abstract

Currently, there are more than 70 types of restoration of gastrointestinal tract (GIT) continuity. Reconstruction of the digestive tract is an important part of surgery on par with lymph node dissection and it must have the following characteristics: gradual emptying into the small intestine, prevention of reflux esophagitis and dumping syndrome, small reservoir size, and reconstructive operative procedures should be relatively uncomplicated and not time-consuming. The technique of GIT reconstruction is the determining factor of postoperative quality of life for the patients. According to the Japanese guidelines, there're two types of reconstruction: with preservation of the duodenal passage and without it. The most known techniques in the duodenal passage exclusion group are Roux-en-Y reconstruction and Roux-en-Y reconstruction with pouch formation. In the duodenal passage preservation group interposition of the jejunum with and without pouch formation are the most common. Currently, Roux-en-Y reconstruction is the preferred technique. The use of Roux-en-Y reconstruction with a pouch to recover the initial anatomical structure significantly decreases the incidence of dumping syndrome and doesn't increase the number of postoperative complications or mortality, operative time, hospitalization time, and significantly increases patients' quality of life. For laparoscopic total gastrectomy, it was shown that intracorporeal anastomosis has a better cosmetic appearance, it's safer, technically feasible, less invasive compared to the extracorporeal anastomosis. Reconstruction using the OrVil device should be used in patients with tumors of the cardia or lower third of the esophagus because anastomosis can be formed high in the mediastinum which increases the probability of negative proximal resection margin after gastrectomy.

Aim: Late radiation injury in the form of radiation-induced fibrosis (RIF) is one of the many complications of radiation therapy. The aim was to evaluate oxygen perfusion in the skin in the area of late radiation injury manifested as RIF in patients with breast cancer. Materials and Methods: Based on our first-hand experience in treating late radiation injures of soft tissues in patients with breast cancer, we measured oxygen perfusion of the skin (tсрО2) in the area of late radiation injury using a transcutaneous monitor (oximeter) TCM 400 (Radiometer, Denmark). Results: Partial oxygen pressure tcpO2 in the RIF area in patients with breast cancer didn’t show any significant decrease compared to healthy tissue. Mean value of partial oxygen pressure tcpO2 in the RIF area was 42.650 ± 9.178 mmHg, in the healthy tissue it was 45.180 ± 8.025 mmHg. Maximal difference in tcpO2 between the damaged and healthy tissue was 30 mmHg. Conclusions: Results of the study suggest that there’s no significant difference between oxygen perfusion (tcpO2) in the area of RIF and healthy tissue.

Introduction. Skin metastases are the result of skin infiltration caused by the proliferation of cells of remotely located malignant tumors occurring with a frequency of 0.6–10.4 % in various oncological processes. They may be a sign of progressive neoplasm or a manifestation of newly diagnosed cancer. Due to a high variability of clinical manifestations leading to misdiagnoses, a limited number of articles describe clinical and dermatoscopic signs of solid tumors metastatic nodes. Aim: to analyze the clinical and dermatoscopic features of skin metastases from breast cancer.Materials and methods. A female patient has complaints of slight pain and itching in the lesions area on the scalp. According to her medical history, a right mastectomy was performed for right breast cancer in 2012, followed by hormone therapy willfully discontinued by the patient. Given the uncommon localization limited with the scalp, the differential diagnosis was made with a spectrum between a cylindroma, multiple basal cell cancer and metastatic carcinoma. A biopsy was carried out to confirm the diagnosis. Results and examination. The pathological skin process revealed itself through multiple nodes up to 2 cm in diameter, pinkish in color, dense, painless on palpation, poorly demarcated. Dermatoscopically: polymorphic vessels on an erythematous background, chrysalis-like structures. Breast cancer metastases were verified by histological and immunohistochemical examination.Conclusion. Skin metastases may be the first sign of cancer recurrence. Dermatoscopy can facilitate differenting them from other skin diseases. Density and diameter of pathological vessels are prognostically significant. Ifdetected lesions do not fit the standard pattern of skin neoplasms, histological verification of the diagnosis is recommended to be carried out.