Immunotherapy has improved the results of treatment of patients with metastatic colorectal cancer. According to literature, the most cancericidal effect revealed in a microsatellite instability high (MSI-H) tumors. In our case, PD-1/PD-L1/PD-L2 inhibitors (nivolumab) treatment for locally advanced MSI-H colon carcinoma with liver metastasis in 44-year-old patient resulted in tumor regression, so that R0 surgical procedure became possible. Computed tomography scan and pathology report showed complete response, in primary and metastatic tumors. As a result, this allowed to improve the quality of patient’s life.

Seborrheic keratosis is the most common benign tumor of the epidermis. Rarely the tumor develops in the perineal area and quite rarely is large. For the Leser-Trelat syndrome these tumors is a marker of a malignant disease even before the symptoms are appeared, as well as a manifestation of the paraneoplastic process. In our case report, a giant perianal seborrheic keratoma was the reason for the clinical examination of the patient and stomach cancer was detected. As a result, we demonstrated a successful experience of surgical treatment of seborrheic keratoma of the perianal area and determined an algorithm for the treatment of stomach cancer.

Resection of “difficult” polyps is associated with high risks of intra- and postoperative complications. About 10 % of polyps are not amenable to endoscopic resection due to technical difficulties. Routinely, for the treatment of big size laterally spread tumors and early tumor of bowel segmental resections is used, which had a significantly higher risks of postoperative complications development. Hybrid laparoendoscopic surgery included a combination of laparoscopic and endoscopic technologies becomes a great opportunity to local bowel resection. This surgical procedure is accompanied by a minimal risk frequency of postoperative complications and the length of stay. In the two clinical cases we demonstrate techniques of hybrid laparoendoscopic surgery for “difficult” endoscopically unresectable polyps of the colon.

The study objective was to evaluate the impact of medical  hospital volume on short-term colorectal cancer treatment results.Materials and methods. The retrospective study included 93 patients with colorectal cancer operated on by one surgeon at two medical centers in Moscow from 2018 to 2020: 32 patients of the first group were operated in tertiary medical center (N.I. Pirogov National Medical and Surgical Center) and 61 of the second group – in regional low volume hospital (Centrosoyuz Hospital). The endpoints of the study were the short-term outcomes: surgery duration, blood loss, postoperative hospital stay, intra- and postoperative complications, lymph node harvested and the quality of specimen.Results. Surgery duration as well as blood loss in two groups were similar (258 min vs 240 min, p = 0.47 and 100 ml and 100 ml, p = 0.89, accordingly). Hospital stay after surgery was significantly less in the first group (9 days vs 16 days, p <0.01). The frequency of postoperative complications of type I–II according to the Clavien–Dindo classification was higher in the first group (6/8 vs 1/8, p <0.05) but reoperations performed more in the second group due to III Clavien–Dindo complications (2/8 vs 7/8, p = 0.012). Grade 2–3 rectal cancer specimen quality was 94.7 % vs 77.8 %, p = 0.13 and harvested lymph nodes >12 was 71.9 % vs 78.7 %, p = 0.485 in first and second group, respectively.Conclusion. Hospital volume does not affect rectal cancer specimen quality, surgery duration and blood loss, if the surgical interventions are performed by one experienced surgeon but associated with the incidence of postoperative complications and the length of stay.

Ulcerative colitis (UC) is an inflammatory bowel disease that mainly affects young people. Colorectal cancer (CRC) is one of the UC complications. This review considers the epidemiology, risk factors, diagnosis and screening, and drug prevention of CRC in UC. Various treatment options for dysplasia and CRC associated with UC are described. Taking into account the lack of literature to standardize colorectal cancer treatment approaches (especially rectal cancer) for UC, further studies are warranted to evaluate both oncological and functional treatment outcomes.