THE COMPLETE PATHOMORPHOLOGICAL RESPONSE TO NEOADJUVANT THERAPY AND ITS ROLE IN THE TREATMENT STRATEGY FOR RECTAL CANCER

The therapeutic strategy in rectal cancer has substantially changed in the past decade. Total mesorectumectomy has been widely used. Many specialized health facilities have accepted radio/chemoradiotherapy for locally advanced rectal cancer as a standard. At the same time as high as one quarter of the patients receiving neoadjuvant therapy demonstrate a complete pathomorphological regression of a tumor. In this connection, the current literature discusses whether medical treatment is permissible in this group of patients

rac-5-Acetyl-6-hy­droxy-3,6-dimethyl-4-phenyl-4,5,6,7-tetra­hydro-2H-indazole

The title compound, C17H20N2O2, is chiral but crystallizes in a centrosymmetric space group as a racemate, the relative configuration at the stereogenic centres being 2S*,3R*,4S*. The cyclo­hexane ring adopts a half-chair conformation while the pyrazole ring has an envelope conformation. The crystal packing displays inter­molecular O—H⋯N and N—H⋯O hydrogen bonding

ABOUT THE SOCIALIZATION OF LABOR AND INCREASE OF SAFETY

A number of aspects of socialization of labor and safety in domestic conditions are revealed in the article, which conceptual bases are based on scientific, standard and empirical levels. The social principles-imperatives and their role in increase of socialization of labor and safety and also neoliberal, conservative and social and democratic social models of the state are considered. The dual character of labor socialization is established as a condition and a source of financing of the public social expenditures and as the instrument of regulation of the social and economic safe relations

ABOUT THE SOCIALIZATION OF LABOR AND INCREASE OF SAFETY

A number of aspects of socialization of labor and safety in domestic conditions are revealed in the article, which conceptual bases are based on scientific, standard and empirical levels. The social principles-imperatives and their role in increase of socialization of labor and safety and also neoliberal, conservative and social and democratic social models of the state are considered. The dual character of labor socialization is established as a condition and a source of financing of the public social expenditures and as the instrument of regulation of the social and economic safe relations

CONSERVATIVE FLUIDS AND LUBRICANTS BASED ON TURBINE OIL, NITRO, AMIDO AND PARAFFIN WAX

To create conservation fluids and lubricants based on the oil acids and polyethylene polyamine (PEPA) synthesized amidoamines, and based on α-olefins (C12, C14 and C16-C18) and the nitric acids-nitro compounds. Using of amido, nitro and solid n-paraffins in the turbine oil T-30 (Standard 32-74) formulated lubricants and conservation fluid which are tested under different conditions. It is shown that in comparison with the preservative fluid, the preservative lubrication more effective

Early experience with the ARTISENTIAL® articulated instruments in laparoscopic low anterior resection with TME

Background: The notion of articulation in surgery has been largely synonymous with robotics. The ARTISENTIAL® instruments aim at bringing advanced articulation to laparoscopy to overcome challenges in narrow anatomical spaces. In this paper, we present first single-center results of a series of low anterior resections, performed with ARTISENTIAL®. Methods: Between September 2020 and August 2021, at the Department of Surgery, St. Marienkrankenhaus Siegen, Siegen, Germany, patients with cancer of the mid- and low rectum were prospectively enrolled in a pilot feasibility study to evaluate the ARTISENTIAL® articulated instruments in performing a laparoscopic low anterior resection. Perioperative and short-term postoperative data were analyzed. Results: Seventeen patients (10 males/7 females) were enrolled in this study. The patients had a median age of 66 years (range 47–80 years) and a median body mass index of 28 kg/m2 (range 23–33 kg/m2). The median time to rectal transection was 155 min (range 118–280 min) and the median total operative time was 276 min (range 192–458 min). The median estimated blood loss was 30 ml (range 5–70 ml) and there were no conversions to laparotomy. The median number of harvested lymph nodes was 15 (range 12–28). Total mesorectal excision (TME) quality was ‘good’ in all patients with no cases of circumferential resection margin involvement (R0 = 100%). The median length of stay was 9 days (range 7–14 days). There were no anastomotic leaks and the overall complication rate was 17.6%. There was one unrelated readmission with no mortality. Conclusions: Low anterior resection with ARTISENTIAL® is feasible and safe. All patients had a successful TME procedure with a good oncological outcome. We will now seek to evaluate the benefits of ARTISENTIAL® in comparison with standard laparoscopic instruments through a larger study

МУЛЬТИДИСЦИПЛИНАРНЫЙ ПОДХОД К ЛЕЧЕНИЮ БОЛЬНЫХ РАКОМ ПРЯМОЙ КИШКИ: ОЦЕНКА КЛИНИЧЕСКОГО И ПАТОЛОГИЧЕСКОГО ОТВЕТА У БОЛЬНЫХ, ПОЛУЧАВШИХ ПРЕДОПЕРАЦИОННУЮ ХИМИОЛУЧЕВУЮ ТЕРАПИЮ

Preoperative staging by digital examination, endorectal ultrasound and magnetic resonance imaging (MRI) allows an assessment of the risk of local recurrence after surgery alone. The successful management of rectal cancer requires a multidisciplinary approach, with treatment decisions based on precise patient evaluations. Chemoradiotherapy (CRT) is associated with reduction of tumor size and downstaging.The aim of this study is to assess how often complete clinical response is achieved after eoadjuvant CRT and its concordance with pathologic complete response.Results. Patients with biopsy-proven, locally advanced rectal cancer (T3, T4) were treated by CRT followed by radical surgery. Tumors were re-assessed after 8 weeks from CRT completion using MRI and endoscopic examination. The results of examination were comparedwith the final histopathologic status.Conclusions. Neoadjuvant CRT leads to significant tumor regression and in some patients there is complete disappearance of neoplasm. MRI combining with colonoscopic findings is a useful tool to evaluate these features.Предоперационное стадирование с использованием инструментальных методов диагностики: эндоректальной ультрасонографии и магнитно-резонансной томографии (МРТ) позволяет оценить риск развития местного рецидива после хирургического лечения рака прямой кишки (РПК).Успешное лечение РПК требует мультидисциплинарного подхода, использования химиолучевой терапии (ХЛТ).Цель исследования: оценить, как часто достигается полный клинический ответ после неоадъювантной ХЛТ и каково его соотношение с полным патологическим регрессом.Результаты. Пациенты с местно-распространенным РПК (T3, T4), морфологически подтвержденным, подвергались ХЛТ с последующей радикальной операцией. Оценка эффекта производилась через 8 нед после завершения ХЛТ с помощью МРТ и эндоскопического исследования. Результаты сравнивались с окончательным гистологическим заключением.Выводы. Неоадъювантная ХЛТ приводит к существенному регрессу опухоли, а у некоторых пациентов к ее полному исчезновению. МРТ вместе с фиброколоноскопией позволяют оценить эффект лечения