ANTIREFLUX RESECTION OF MUCOUS MEMBRANE OF ESOPHAGOGASTRIC ANASTOMOSIS IN TREATMENT OF BARRETT’S ESOPHAGUS: INITIAL EXPERIENCE

Antireflux resection of mucous membrane of esophagogastric anastomosis (ARMS) was performed on 6 patients with typical symptoms of gastroesophageal reflux disease (GERD). The patients had a short segment of сolumnar-celled metaplasia (1-2 cm) without radiological and endoscopic signs of hiatal hernia. All the patients received medicamentous therapy by antisecretory agents more than 3 years. The operation included the endoscopic resection of2/3 circle of mucous membrane of esophagogastric anastomosis and resection of the area of columnar-celled metaplasia. The results of treatment were assessed during 3-7 months after ARMS. There was noted an absence of clinical manifestations of GERD, regression of inflammatory signs of mucous coat of esophagus in 4 out of 6 patients. Symptoms of GERD remained in 2 patients, although the intensity of signs significantly decreased

PREVALENCE OF ESOPHAGEAL SYNDROMES OF GASTROESOPHAGEAL REFLUX DISEASE IN POPULATION OF LENINGRAD REGION (ACCORDING TO ESOPHAGOGASTRODUODENOSCOPY FINDINGS)

The article presents an analysis of 34.903 esophagoscopy results performed for population of Leningrad region at the period from 2007 to 2013. A prevalence of erosive esophagitis was 4,9%, peptic strictures - 0,18%, columnar-celled metaplasias - 1,43% and esophageal adenocarcinoma - 0,645%. The data obtained showed a high prevalence of GERD-associated syndromes with injury of mucous coat of esophagus in the local population of Russians

Infrared fluorescence guided pleural biopsy during thoracoscopy

OBJECTIVE. The authors developed methods and assessment of efficacy of infrared fluorescence imaging of pleural carcinomatosis using indocyanine green (ICG). MATERIAL AND METHODS. The prospective study included 14 patients with malignant pleural carcinomatosis. All patients underwent standard thoracoscopy with pleural biopsy, then pleural cavity was examined under fluorescence control using ICG solution. Comparison of accuracy of biopsy materials obtained in white light and fluorescence was made. RESULTS. Signs of malignancy had 21 biopsy specimens out of 28, which were obtained in white light (in 12 patients out of 14). Research of biopsy specimens using fluorescence allowed doctors to make the precise diagnosis in all 14 patients, with 33 out of 34 biopsy materials being informative. CONCLUSIONS. Intraoperative application of infrared ICG fluorescence developed accuracy of biopsy and histological verification of the diagnosis

EXPERIENCE OF THE USE OF ENDOVIDEOTECHNOLOGY IN SURGICAL TREATMENT OF ESOPHAGEAL CANCER

An investigation included 33 patients with cancer of thoracal section of the esophagus at the age from 42 to 74 years old. A surgical method of treatment was applied as only one in 13 patients and methods of nonadjuvant chemoradiation therapy were used for 20 patients. A hybrid minimally invasive esophagectomy (laparoscopic mobilization of the stomach and right-side thoracotomy) was performed on 16 patients. The rate of postoperative complications consisted of 31%. The minimally invasive esophagectomy (performed by totally endovideosurgical approach) was carried out in 15 cases. Postoperative complications developed in 53% of follow-up patients. There weren’t cases of lethality. The experience of minimally invasive methods indicated the satisfactory results of application of given methods in patient treatment of esophageal cancer. The use of endovideosurgical approaches allowed performing oncologically adequate volume of operative interventions

Reduction of resection volume in patients with non-small cell lung cancer after neoadjuvant chemoand photodynamic therapy

OBJECTIVE. The research evaluated efficacy of combined treatment of initially nonresectable and inoperable cases of non-small cell lung cancer. The treatment consisted of preoperative endobronchial and intraoperave photodynamic therapies. MATERIAL AND METHODS. The prospective investigation included patients with central non-small cell lung cancer. These cases were initially considered as nonresectable (the trachea was involved in tumor) or inoperable (functional intolerance of pneumoectomy/ bilobectomy). Neoadjuvant chemotherapy (2-6 courses) and endobronchial photodynamic therapy (PDT) were conducted for these patients in preoperative period. PDT of resection edge was carried out during the operation and it was straight away after specimen removal and ipsilateral lymphodissection. RESULTS. The research was made on 38 patients. Lung resections underwent 30 (79 %) patients. Surgeries included 20 pneumoectomies and 10 lobectomies. Bronchial resection was performed by crossing an initially affected zone. It was noted that 5-year survival consisted of 68 %. CONCLUSIONS. Photodynamic therapy was important in combination with chemotherapy and surgical treatment of central non-small cell lung cancer. These measures allowed doctors to decrease the resection volume in part of inoperable patients or patients with initially nonresectable tumors