Zolotukhin S. Advanced cancer of the rectum. Ways to increase the treatment efficiency.

Object - patients with advanced rectal cancer. The purpose - to define the optimal treatment tactic of patients with advanced rectal cancer to increase the duration and improved the quality of life. Methods - clinical examination, endoscopical examination of the thick gut (rectoromanoscopy, colonoscopy, instrumental definition of mobility of the tumor), radiological examination; ultrasound and computer tomography; statistical analysis; efficiency of treatment of patients was estimated by five years' survival rate by a method suggested by V.V.Dvojriny. Results - essentially new approach to treatment of partial mobile and immobile forms of a tumor which will consist in transformation of locally non-resectabel process in a resectabel condition which allows to execute radical and palliative resections in most of cases; the satisfactory direct, remote and functional results are received at prevailing performance of at one-time reconstruction and sphincter-save interventions; is proved the expediency of performance citoreductives at-one-time reconstruction and sphincter-save resections which were carried out situationally after revision of the peritoneal cavity and the diagnosis of non-ablational tumorals widespreads; the satisfactory remote results which considerably exceed similar parameters after conservative methods of treatment are received; in case of treatment non-resectabel and advanced forms of rectal cancer which are not subject radical operative intervention, is established high efficiency of the developed method of combination radiological treatment and endolymphatic chemotherapy. Novelty - at first time the comparative analysis of results of application different methods of combined and complex treatment of the widespread forms of recta cancer is submitted, is offered a effective medical tactics of transformation locally non-resectabel process in a resectabel condition; is shown the possibility and efficiency of surgical removal of such tumors; efficiency of the complex methods of palliative endolymphatic chemotherapy and radiological treatment of inoperable patients with rectal cancer is proved; is carried out the comparative analysis of efficiency neoadjuvant, adjuvant and palliative methods of treatment of the widespread forms of rectal cancer; is proved the erroneous way of ablation of the sphincter device or performance of obstructive resections at such forms of cancer; the possibility and efficiency of performance radical and palliative at-one-time reconstruction and sphincter-save resections is shown; on the basis of the remote results is proved the possibility of preservation the natural passage of intestinal contents at inoperable patients with locally advanced rectal cancer. It is introduced in the oncological centers, clinics and oncological departments in Artemovsk, Mariupol, Donetsk, Gorlovka, Kramatorsk, Lugansk, Dnepropetrovsk, Kharkov cities. Area - medicine (oncology