The problem of treating patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla remains relevant due to the growing incidence, high mortality, and a pronounced decrease in the quality of life of patients, despite the radical surgery. The purpose of this study was to evaluate the effectiveness of photodynamic therapy (PDT) in inoperable patients with malignant tumors of these localizations.The study is based on the treatment of 79 patients with adenocarcinoma of large duodenal papilla and extrahepatic bile ducts. 29 patients received palliative bile drainage operations with PDT. 50 patients in the control group only had palliative bile drainage operations. Patients in the study group received from 1 to 3 PDT courses in a year. In total, 29 patients received 52 PDT courses. The tolerance to the method and the life expectancy of patients were evaluated. The median survival of patients who underwent PDT was 18 months (11–60 months); in the control group – 11.5 months. PDT, in combination with bile drainage operation, is an effective method for the treatment of inoperable patients with malignant neoplasms of the extrahepatic bile ducts and the large duodenal papilla in the absence of severe complications and with easy tolerance to therapy by patients. For the treatment and prolongation of life of patients whose radical surgical treatment is associated with a high risk of death, PDT seems to be the best treatment option. Results of PDT treatment for cancer of this localization are comparable with the results of radical surgeries and exceed those for palliative surgeries.

The study aims to evaluate the eff ectiveness of standard and modifi ed settings of the spectral color allocation technology in the diff erential diagnosis of the colon morphological type of epithelial formations. Materials and methods: video colonoscopy using standard and modifi ed mode of technology. A total of 746 patients were selected for spectral colour selection, of whom 80 were selected. There were 36 men, 44 women. The average age of the patients was 60 ± 9 years. There were 171 epithelial fomations, of which 106 (61.9%) were located in the left side of the large intestine: in the rectum — 33 (31.2%), in sigmoid — 52 (49%), in descending part — 21 (19.8%). In the right parts of the colon there were significant lower number of formations — 65 (38.1%): ascending intestine — 26 (40%), transversely — colon — 32 (49.2%), cecum — 7 (10.8%). Endoscopic studies were performed according to standard method using video colonoscopes from Fujinon, EC-590ZW / L, EC-530WL. Results: statistically revealed that the probability of determining the correct morphological type of epithelium is formation is 6 times higher when using the modifi ed spectral color technology highlight compared to standard technology settings. Conclusion: the modifi ed settings of the technology of spectral color highlighting allow much more accurative performance an optical biopsy of epithelial colon formations.

Толстокишечная непроходимость опухолевого генеза продолжает оставаться актуальной проблемой экстренной хирургии. На данный момент в данной ситуации возможно выполнение различных вмешательств. Колоректальное стентирование является предпочтительный методом паллиативной помощи. Однако роль стентирования у пациентов с курабельными или потенциально курабельными опухолями остается неуточненной. В данной обзорной статье представлены данные метаанализов, рандомизированных и когортных исследований, а также рекомендаций, позволяющих определить роль предоперационного колоректального стентирования.

The aim: to focus on the possibilities of modern endoscopy in the diagnosis of laterally spreading (creeping) tumors — LST (laterally spreading tumor) of the colon.Materials and methods: description and comparison, based on data available in the literature, of modern endoscopic techniques for the diagnosis and differential diagnosis of LST.Results: the analysis and systematization of the obtained data revealed the advantages of modern endoscopic diagnostic methods not only in detecting LST, but also in predicting their morphological structure.Conclusion: the use of modern endoscopic diagnostic methods allows not only to improve the detection of neoplasms, but also to choose the best options for further treatment based on the information received.

Purpose: To find out a technique for determining the effectiveness of porphyrin-type photosensitizers with concentrations which cause hemolysis in erythrocytes (hemolysis threshold). The hemolysis threshold is found under the following conditions: irradiation in the Soret band with standard parameters – power density, exposure dose, irradiation time.Material and methods. Phototherapeutic device “AST” (LLC “Pankov-medical”) – average power 0.5 W, wavelength ≈ 405 nm. Rat blood erythrocytes. “Multiscan MS” device manufactured by Labsystems, Finland. Preparation “Dimegin”, hematoporphyrin derivative; preparation “Photoditazine” (LLC “VETA-GRAND”), chlorine E6 derivative.Results. On analyzing the results obtained after experimentation with the abovementioned two preparations, it was shown that the developed technique has a high efficacy. It was also shown that the studied photosensitizers are equally effective when irradiated in the Soret band.Conclusion. The developed technique is simple and easy to use. It helps to assess the efficacy of various photosensitizers thus, facilitating the selection of their necessary concentrations for managing different diseases.