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The objective: to determine the indications and possibility of surgical treatment of giant malignant intrathoracic tumors.Subjects and Methods. The authors presents their own experience of treatment of 19 patients with giant malignant intrathoracic tumors.Results. Overall resectability was 79% (15/19 patients). 4 patients underwent combined surgery: in 2 patients, the tumor was removed with resection of a part of the upper lobe of the lung; 1 patient had this left lung resected (pneumoectomy); and 1 patient had type A thymoma, so resection and reconstruction of the pulmonary arterial trunk was performed. Radicality was assessed both during surgery (R2 – in 3 patients) and during morphological testing of surgical specimens (R1 – in 1 patient).Among the operated giant neoplasms of the chest, which did not include lymphomas and extra-gonadal dysgerminogenic tumors, thymoma (7/19; 36.8%) and neoplasms of neurogenic origin (3/19; 31.6%) of varying degrees of differentiation were more often diagnosed.The examination algorithm of these patients and decision-making on surgical tactics are presented. The article discusses access options and technical surgical methods for removing large tumor masses with a specific clinical examples.

Objective.Radical prostatectomy (RPE) performed without preserving the neurovascular bundles and the pubovesical complex has a great risk of developing urinary incontinence and erectile dysfunction, which significantly impairs the quality of life of patients with prostate cancer in the postoperative period. Methods. The effectiveness of surgical treatment was assessed in 22 patients (mean age 57.6 ± 6.4 years) with a diagnosis of prostate cancer, who underwent extraperitoneoscopic intrafascial nerve-saving radical prostatectomy with preservation of the pubovesical complex. The criteria for the effectiveness of this technique of surgical treatment were considered the preservation of erectile function and the absence of urinary incontinence in the early and late postoperative period. Results. In the postoperative period, all patients were continent; in 3-4 months, erectile function was restored without additional stimulation by phosphodiesterase-5 inhibitors. Conclusions.The described technique demands detailed understanding by the surgeon of the surgical anatomy of the prostate and the basic surgical principles of nerve preservation in order to significantly improve the quality of life of patients in the postoperative period.

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