Objective: To assess the effectiveness of relatively curative surgical interventions in the treatment of patients with gastric cancer with metastases to the liver and to show the role of active surgical tactics in improving the quality of life of patients. Methods: The study included 28 patients with gastric cancer with metastases to the liver. Patients with type I and type II Borrmann’s tumor growth (17 (85.7%) patients) were prevalent. It was found that in the predominant majority of patients had lesions of regional lymph nodes (91.6%). Detection of ultrasound and CT studies of enlarged retroperitoneal lymph nodes, lymph nodes of the aortocaval space, as well as massive invasion of the serous cover of the stomach with the extra organ component detected by laparoscopy, is a contraindication for performing simultaneous operations on the stomach and liver. In 14 (50%) patients,surgical interventions were carried out against the background of a complicated clinical course of gastric cancer: in the presence of pylorostenosis in 9 (32%) cases and torpid (sluggish) bleeding in 5 (17.85%) cases. Results: Analyzing the primary tumour and metastatic hearth in the liver, we came to the conclusion that gastric cancer with gastric metastases in the liver should be resected in cases of highly or moderately differentiated adenocarcinoma that has exophytic or mixed forms of growth, preferably with the intactness of the serous cover of the stomach. Practically in half of the patients in our series, the metastasis in regional lymph nodes are revealed,however, only in two, the defeat of lymph nodes of the second – order was diagnosed. Thus, “resectable” liver metastases can occur even at the N0 stages. In the studied group, patients with type I and II Borrmann’s prevailed with type I and II, most of them showed the intestinal histological type of a tumour. Conclusion: Liver resection for gastric cancer metastases should be performed under the following conditions: the absence of other distant metastases (peritoneum, non-regional lymph nodes, etc.); performing “radial” gastrectomy with D2-D3 lymphadenectomy; the possibility of carrying out macroscopic radical resection of the liver; functional portability of the operation; physiological operability. Keywords: Gastric cancer with liver metastases, palliative operations, indications, prognosis.

1 кафедра онкологии и лучевой диагностики, таджикский государственный медицинский университет им. абуали ибни сино, душанбе, Республика таджикистан 2 Республиканский онкологический научный центр, душанбе, Республика таджикистан 3 кафедра онкологии, институт последипломного образования в сфере здравоохранения Республики таджикистан, душанбе, Республика таджикистан 4 Эндоскопическое отделение, национальный медицинский центр «шифобахш», душанбе, Республика таджикистан Рак желудка -одна из наиболее часто встречающихся злокачественных опухолей человека. Рак возникает, как правило, на фоне хронических воспалительных заболеваний желудка, и в настоящее время установлено, что в абсолютно здоровом желудке неопластические изменения невозможны. Им предшествует предраковое состояние, которое имеет место при хроническом анацидном гастрите, каллёзной язве и полипе желудка. В среднем, от предрака до рака проходит от 10 до 20 лет. Развитие рака желудка на фоне инородного тела -явление крайне редкое. Возможными причинами этой трансформации является длительное нахождение инородного тела с развитием циркулярного неопластического вала вокруг него. В статье представлен результат хирургического лечения больного с раком желудка, развившимся на фоне инородного тела. Ключевые слова: рак желудка, инородное тело, диагностика, хирургическая тактика, прогноз. Для цитирования: Юлдошев РЗ, Зикиряходжаев ДЗ, Хусейнзода ЗХ, Ходжамкулов АА, Азатуллоев ЁИ, Бобоев ИК, Абдуллоев АА, Дилшодов СМ. Развитие рака желудка на фоне инородного тела. Вестник Авиценны. 2019;21(1):173-7. Available from: http://dx.of tajikistan 3 department of oncology, institute of Postgraduate education in healthcare of the Republic of tajikistan, dushanbe, Republic of tajikistan 4 endoscopic department, «shifobakhsh» national medical Center, dushanbe, Republic of tajikistanGastric cancer is one of the most frequently encountered malignant human tumors. Cancer usually occurs, as a rule, on the background of chronic inflammatory diseases of the stomach, and it is now found that in an absolutely healthy stomach, neoplastic changes are impossible. They preceded the pre-cancerous condition that takes place with chronic anacid gastritis, callous gastric ulcer, and gastric polyps. The average, from pre-cancerous condition to cancer is from 10 to 20 years. The development of gastric cancer on the background of the foreign body is an extremely rare phenomenon. Possible causes of this transformation are the long-term presence of foreign body with the development of a circular neoplastic shaft around it. The article presents the result of surgical treatment of a patient with stomach cancer that developed on the background of a foreign body. For citation: Yuldoshev RZ, Zikiryakhodzhaev DZ, Khuseynzoda ZKh, Khodzhamkulov AA, Azatulloev YoI, Boboev IK, Abdulloev AA, Dilshodov SM. Razvitie raka zheludka na fone inorodnogo tela [Development of gastric cancer on the background of the foreign body]. Vestnik Avitsenny [Avicenna Bulletin]. 2019;21(1):173-7. Available from: http://dx.

1 Кафедра онкологии и лучевой диагностики, Таджикский государственный медицинский университет им. абуали ибни Сино, Душанбе, Республика Таджикистан 2 отделение хирургии опухолей верхних дыхательно-пищеварительных путей, Российский онкологический научный центр им. н.н. Блохина, Москва, Российская федерация В статье представлен обзор современной литературы, посвящённой заболеваемости, смертности, эволюции реконструктивно-восстановительных операций и алгоритму их применения при раке органов головы и шеи. Отражены результаты проведённых рандомизированных исследований по хирургическому лечению рака головы и шеи и проблемы, связанные с реабилитацией и качеством жизни этих больных. В частности, приведён опыт ведущих специалистов в области реконструктивно-восстановительных операций при опухолях отдельных локализаций. Проанализировано влияние одномоментной пластики на качество жизни больных. Сравнение результатов применения лоскута большой грудной мышцы и свободного лоскута из переднебоковой поверхности бедра показало, что частота осложнений во втором случае намного меньше. Изучена эффективность паллиативных операций с одномоментной реконструкцией свободными лоскутами и лоскутами на ножке у пациентов с местнораспространённым раком головы и шеи. Ключевые слова: местнораспространённый рак, голова и шея, реконструкция, лоскуты, реабилитация, качество жизни.Для цитирования: Сангинов ДР, Мудунов АМ, Юлдошев РЗ, Базаров НИ, Ниязов ИК, Сафарзода НА. Реконструктивно-восстановительные операции и вопросы качества жизни больных с местнораспространённым раком головы и шеи. Вестник Авиценны. 2019;21(1):165-72. Available from: http:// dx.The article presents an overview of modern literature on the incidence, mortality, evolution of reconstructive and plastic operations and the algorithm of their application in cancer of the organs of the head and neck. The results of randomized studies on the surgical treatment of head and neck cancer and the problems related to rehabilitation and quality of life of these patients are reflected. In particular, the experience of leading experts in the field of reconstructive surgeries for tumors of individual localizations is given. The influence of one-stage plastics on the quality of life of patients is analyzed. Comparison of the results of the application of the pectoralis major myocutaneous flap and the anterolateral thigh free flap showed that the frequency of complications in the second case is much less. The effectiveness of palliative operations with simultaneous reconstruction with free and pedicled flaps in patients with locally advanced head and neck cancer was studied. Information about the source of support in the form of grants, equipment, and drugsThe authors did not receive financial support from manufacturers of medicines and medical equipment.

The article presents a case of a combination of stomach cancer and jejunal diverticulosis in a 71-year-old female patient. Stomach cancer was diagnosed preoperatively both clinically and by instrumental (endoscopic and radiological) and pathomorphological methods. During the surgery, jejunal diverticulosis was accidentally revealed. Considering the stomach cancer resectability and the presence of diffuse intestinal diverticulosis, resection of the proximal jejunum, distal subtotal gastrectomy, Roux-en-Y gastroenteroanastomosis, and D2 lymphadenectomy were performed. The immediate postoperative period was complicated by perforation of the anterior wall of the resected stomach, and defect was urgently sutured. Control X-ray examination showed that both the stomach and gastroenteroanastomosis were normal, the passage of contrast through the jejunum was satisfactory. The patient was discharged home on the 12th day in satisfactory condition.