The aim: The purpose of the study is to improve the results of treatment of patients with acute intestinal obstruction of tumor origin by developing individualized surgical tactics considering the level of cryoglobulins. Materials and methods: 96 patients with ileus of tumor origin were studied. The mean age of patients was 54.7 ± 5.9 years. 30 patients were diagnosed with colorectal cancer, 35 patients - with sigmoid cancer, 13 patients - with cecum and ascending colon, 11 patients - with transverse colon cancer, and 7 patients with descending colon cancer. Isolation of cryoglobulins from blood serum was performed by the method of A. E. Kalovidoris with modifications. The content of Ig A, Ig M, Ig G, total Ig E in the serum was investigated using enzyme-linked immunosorbent assay systems “Granum-Ukraine”, the content of allergen-specific Ig E was investigated using enzyme-linked immunosorbent assay systems produced by “Microgen”. Results: As a result of treatment of 96 patients, it was found that the level of development of postoperative purulent complications was significantly influenced by the level of cryoglobulinemia and the volume of surgery (CMU, p <0.05). It was found that in patients with decompensated intestinal obstruction, the initial concentration of cryoglobulins was 16.4% higher than in the group with compensated intestinal obstruction (CMU, p <0,05). Conclusions: Determination of cryoglobulinemia on admission of patients with acute obstructive ileus of tumor origin is a simple and effective method for predicting the development of purulent-inflammatory complications in the postoperative period and can influence the choice of treatment tactics.

The combination of socially significant common chronic non-infectious diseases of internal organs, the interaction of their pathogenetic links quite often leads to the development of complications that affect the course of the main nosology. Among these tandems, chronic pancreatitis and hypertension are considered — calcium-dependent diseases, the comorbidity of which can affect the disturbances in calcium metabolism, thereby contributing to the formation of osteopenic conditions. A number of researchers have established that the development of diseases such as chronic pancreatitis and hypertension, and their complications (namely, osteoporosis) can be the result of the presence of candidate genes, the unfavorable polymorphism of which can provoke changes in the pathogenetic directions of the diseases course.

The study and analysis of the treatment outcomes were carried out in 69 patients aged from 40 to 85 years (mean age 53.0±1.0) who had tumours of the body or cardiac part of the stomach T3-4 (according to the UICC classification (ninth edition, 2014)). The distribution of patients according to the localization of tumour lesions in the stomach was as follows: 43 (62.3%) cases found in the body region and 22 (31.9%) found in the proximal section (of which 14 (20 3%) were in the cardia (Type III according to Siewert J.R.), 8 (11.6%) patients had the transition to the abdominal oesophagus (type II according to Siewert JR), 4 (5.8%) patients had the tumour located in the stump of the resected organ. Histologically, the vast majority of neoplasms were represented by adenocarcinoma (94.8%). All other types of tumours made up for 5.2%. The patients received photodynamic therapy with the Photolon photosensitizer and subsequent irradiation with a laser with a wavelength λ = 0.67 μm crossed irradiation fields, which was introduced through the biopsy channel of the endoscope. The light dose and the number of irradiation sessions were determined depending on the degree of damage to the oesophagus and stomach (from 4 to 7 sessions). The light dose of the session was up to 200 J. The power density of the laser radiation is 25 mW/cm2. Endoscopic photodynamic therapy can be used at the stage of combined treatment in combination with chemotherapy and surgery and is an effective means of preventing the failure of the oesophageal-small intestinal anastomosis in the early postoperative period. Due to photodynamic therapy in the preoperative period, the number of complications in the early postoperative period has significantly decreased. The leakage of the oesophageal-intestinal anastomosis developed in 4 cases, which make up 5.8%.

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The prevalence of comorbidities has been growing for the last decades. Therefore, the detection of biomarkers for diagnostic and prognostic purposes is of great practical importance. The aim of this study was to assess the biomarkers of osteo-defficiency in the course of secondary osteoporosis in patients with comorbid chronic pancreatitis and arterial hypertension. We examined 110 patients with chronic pancreatitis: 70 of them had comorbid hypertension, and 40 patients were found as having no comorbidities. The age of patients ranged from 33.2 ± 2.1 (main group) and 32.9 ± 3.1 years (comparison group); women predominated (72.9% and 70%, respectively). The control group includes 78 healthy individuals of the same age and sex. Diagnostic investigation included studying clinical and anamnestic characteristics of patients (duration of the disease, manifestations of the course, frequency of recrudescence, fractures) and biochemical parameters of bone metabolism: osteocalcin, total bone phosphatase and tartrate-resistant acid phosphatase and the establishment of correlations between these parameters and incidence of complications. It was found that in the isolated course of chronic pancreatitis there is a high (R = 0.60) statistically significant (p <0.01) correlation between the levels of osteocalcin and pancreatic elastase-1. A negative statistically significant (p <0.01) mean correlation (R = -0.49) was found between the content of tartrate-resistant acid phosphatase and age of the patients having comorbidity of chronic pancreatitis and hypertension, as well as there is a moderate correlation between the content of tartrate-resistant acid phosphatase and the duration of hypertension, which is statistically significant (R = 0.36, p <0.01). The levels of total bone phosphatase and tartrate-resistant acid phosphatase in the main group exceeded the reference values in 2.5 and 1.9 times respectively (CMU; U = 866.0; p <0.01), while in the comparison group were 2 times (total bone phosphatase) and 1.3 times higher (tartrate-resistant acid phosphatase) times, respectively (CMU; U = 821.0; p <0.01) that enables to diagnose the development of osteopenic conditions. That is, the combined course of chronic pancreatitis and hypertension should be considered as unfavourable tandem in the development of secondary osteoporosis and requires early osteoporotic screening.