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Aim. To improve the surgical treatment results among patients with synchronous liver metastasis of colorectal cancer. Materials and methods. From 2012 to 2019, the analysis of the results of treatment of 60 patients with colorectal cancer and synchronous metastatic liver disease was carried out. The study sample was divided into 2 groups of patients. The group 1 consisted of 30 patients who got simultaneous resection of liver metastases and primary colorectal cancer. The group 2 consisted of other 30 patients who got stage resections: surgery for the primary tumor at the first stage, and liver surgery for metastases at the second.Results. The median operative time was 340 ± 21.1 minutes in the group 1. In the group 2 it was 255 ± 21.1 minutes and only the liver resection stage was assessed. The median blood loss in patients of the group 1 was 520,0 [200,0;800,1] ml, in the group 2 it was 500,0 [175,0;1300,0] ml. In general, we identified 5 cases of complications. In the postoperative period, 4 patients died. The average follow-up period is 23 months. One-year survival in group 1 was 92.6%, in group 2 – 100%, three-year – 85.2% and 89.6%. One-year disease-free survival in group 1 is 70%, in group 2 – 83.3%, three-year disease-free survival – 43.3% and 36.7%.Overall and disease-free survival rates didn’t differ significantly between the two treatment strategies. We detected significant effect on the disease-free and overall survival of regional lymph nodes metastasis (both p < 0.05).Conclusion. The long-term and immediate results of simultaneous surgery of synchronous liver metastasis of colorectal cancer are comparable to the results of the staged method of treatment. It indicates the safety and effectiveness of simultaneous procedure.

Relevance. Formation of pulmonary hypertension (PH) in myocardial infarction (MI) remains poorly understood. Aim. To evaluate changes in pulmonary circulation indicators (PCI) in men under 60 years old (y.o) with PH that is developing in subacute MI period to improve understanding of developmental options and prevention. Material and methods. The study included men aged 19-60 y.o. with MI and various dynamics of mean pulmonary ar-tery pressure (MPAP), determined by echocardiography (A. Kitabatake) in the first 48 hours (1) and completion of third week (2) of MI. Patients were divided into four groups: studied (I) included 84 patients (mean age 50.4±7.1 y.o) with PH (MPAP2 25 and more mm Hg) and normal level of MPAP1. Group II included patients with a normal level of MPAP in both phases of the study (88 men, 52.1±6.6 y.o); group III – with elevated levels of MPAP at both points of study (184 men, 51.2±5.5 y.o) and IV – with increased levels of MPAP1 and normal levels of MPAP2 (94 men, 50.5±6.8 y.o). A comparative assessment of PCI in selected groups was performed. Results. In first 48 hours of MI, the minimum values of MPAP (I: 21.9±3.3; II: 20.3±2.5; III: 39.0±11.2 (mm Hg)) and total pulmonary resistance (TPR) ) (I: 380.0±171.0; II: 306.8±136.3; III: 616.0±279.8 (dyn×sec×cm-5)) were noted in group II, and the maximum - in III (p˂0.0001). When considering their dynamics at the end of the third week of MI, MPAP increased in I (39.5%; p˂0.0001), decreased in III (16.0%; p˂0.0001) and IV groups (42.9%; p˂0.0001). TPR decreased in II (12.1%), III (28.6%) and IV (54.2%) groups (p ˂0.0001). Conclusions. The study group is distinguished by unfavorable changes in PCI during observation period, in contrast to other groups, which confirms expediency of assessing dynamics of these parameters as possible marker of negative prognosis for PH.

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