The article presents a complex clinical case of a patient with primary multiple cancer, with lesions of the prostate, bladder, ureter, stomach, regional and distant lymph nodes. Initially, it was assumed that there were four localizations of cancer, but after performing the operation and conducting thorough morphological and immunohistochemical studies, it became possible to prove that only two cancer localizations were present, namely prostate cancer and stomach cancer. The implementation of complex palliative (salvage) surgical interventions as the first stage of the complex treatment of prostate and bladder cancer, as well as the performance of simultaneous operations, can improve the prognosis of patient survival.
The review provides an analysis of the literary data devoted to the problem of surgical treatment of duodenal stenosis combined with ulcer penetration. Still in the scientific literature has an ambiguous interpretation of the concept of ulcer penetration: it also exceptionally includes the presence of a large ulcerative crater penetrating into a neighbouring organ with periulcerous inflammatory infiltrate. Hereby, cicatricial adhesions with neighboring organs, as the result of preceded ulcer penetration, are not considered penetration. There are controversial views among the surgeons regarding surgical tactics, volume and surgical technique. The particular situation in surgery of duodenal ulcer is domination of resection methods over organsaving techniques. There’s a wrong opinion of impossibility of organ-saving surgery in penetrating duodenal ulcer. In recent years, the methods of low-invasive surgery have become increasingly popular. The analysis of literary data shows that there is insufficient knowledge of this problem, the debatability of a number of issues requiring their final solution.
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