Introduction. The study aimed to evaluate a routine accelerated recovery management in patients with extended combined pelvic surgery.Materials and methods. We surveyed the records and outcomes in various oncological patients following the accelerated recovery protocol after a routine extended combined pelvic surgery at the Moscow City Oncology Hospital No. 1 during 2018–2020.Results and discussion. Locally advanced tumours comprised 37 (75.5 %) cases, and the remaining 12 (24.5 %) were nonpelvic resections due to metastasis. Radical surgery was achieved in 41 (83.7 %) cases, while the other 8 (16.3 %) were symptomatic due to the emerged complications of intestinal permeability disruption, bleeding, urinary obstruction, paracancrotic abscess, internal fistulae or pain syndrome. Postoperative complications were evaluated in the Clavien-Dindo classification.Conclusion. The results obtained suggest the feasibility of an accelerated recovery protocol-based practice in extended combined pelvic surgery.
The patients with gastric cancer (GC) sometimes have a very poor prognosis. In general, it depends on the time of GC verification, which dramatically changes prognosis and treatment plans. This article reflects current data on the epidemiology, mortality rate, and rates of the incidence of gastric cancer in different countries of the world. The most common and clinically convenient classifications and staging systems for gastric cancer are given, the need for the earliest possible diagnosis and verification of the stage of the tumor process is substantiated. There are considered in details the modern methods of the gastric cancer diagnostics, including esophagogastroduodenoscopy (EGD), as the method of choice for the primary detection of gastric cancer, and various methods of radiation imaging, including multispiral computed tomography and endoscopic ultrasonography (EUS), combined with chromoendoscopy, narrow-band tomography, and confocal laser endoscopy. Particular attention is paid to the presentation of various methods of preoperative T-staging and N-staging of gastric cancer, comparing the diagnostic accuracy of MSCT and endoscopic ultrasonography. Diagnostic accuracy, sensitivity, and specificity of magnetic resonance imaging (MRI) and positron emission tomography (PET) are presented. Special attention is paid to the comparative analysis of the effectiveness of various imaging techniques in assessing the effectiveness of neoadjuvant chemotherapy; the results of tumor volumetry are compared with the histological response according to the Mandard score. Further prospects for the application and development of radiological research techniques are discussed.
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