Medical article медицинская статья

Эхинококкоз: основы диагностики и роль миниинвазивных технологий (обзор литературы)

Colorectal cancer typically metastasizes to the peritoneum, liver, and lungs. However, metastases to the fallopian tube and uterus are uncommon. This case report delves into this rare occurrence of metastasis and discusses its characteristics, diagnostic methods, and treatments based on an extensive literature review. We present the case of a 61-year-old female patient who underwent her initial hospitalization for da Vinci robotic surgery to address colorectal cancer, stage pT3N0M0. However, during routine postoperative follow-up 6 months later, a localized rectal recurrence was detected. The patient commenced chemoradiotherapy with full response. Subsequently, the patient was readmitted due to pelvic pain again, and a magnetic resonance imaging scan revealed an abnormal mass in the patient’s left fallopian tube and uterine corpus, infiltrating the myometrium. Consequently, total hysterectomy with bilateral adnexectomy was performed, along with omentectomy, which confirmed metastatic involvement from rectal cancer upon postoperative pathological examination. This case may inform further diagnosis and treatment of colorectal cancer metastasis to the fallopian tube.

Currently, photodynamic therapy (PDT) remains the most effective treatment for actinic keratosis (AK). With the increase in the incidence of AK, mainly due to the popularization of recreation in countries with increased insolation, there is an increasing interest in developing new methods of diagnostics and treatment and improving the existing ones. Studies that are aimed at determining the final efficacy of PDT, taking into account the resulting adverse reactions and long-term cosmetic results, are becoming increasingly popular. The nature of the light needed to excite a photosensitizer (PS) opens up new possibilities in the field of experimental studies that are aimed at reducing adverse reactions with similar efficacy of the applied therapy. In the review article, we presented the results of our own and foreign studies on the diagnosis and treatment of AK for 2017–2019, namely: we determined the possibilities of using sources with natural and short-wave radiation at different depths of skin lesions; presented a classification of the growth of AK in the basal layer of the epidermis, which increases the possibility of predicting the outcomes of the disease; showed the prevailing efficiency of fluorescent diagnostics compared with traditional diagnostic methods; evaluated the advantages of PDT using natural light and artificial sources of radiation; described the possibility of using a combination of drugs to increase the effectiveness of PDT in difficult to treat areas and in AK foci with a high degree of damage to the basal layer of the epidermis.

The purpose of the study was to assess the feasibility of using the propeller flap to cover a large axillary fossa defect following lymph node dissection in breast cancer patients.Material and Methods. One hundred breast cancer patients underwent surgery. Out of them, 64 underwent Madden modified radical mastectomy and 36 radical breast resection using a propeller muscle flap. Out of 100 patients, 61 were followed up (50 after mastectomy and 11 after radical resection using a propeller flap). Fifteen patients were randomly selected for examination of the flap using ultrasound (2 patients after radical resection, 13patients after radical mastectomy). The follow-up time was from 3 to 6 months. We studied the following: bleeding in the postoperative period, hematoma, duration of lymphorrhea, duration of hospitalization, ultrasound findings, hand function, size of the upper limb, and physical activity.Results. No statistically significant differences in the number of complications related to the surgery extent were found. Here was no bleeding. Small hematoma was observed in one patient who underwent breast resection. Forty-three (70.49 %) patients did not have lymphorrhea after drainage removal. Lymphorrhea was observed for a month in 9 (14.75 %) patients, for 1–2 months in 4 (6.56 %) patients, and for 3 months or more in 5 (8.2 %) patients – 3 months or more. Twelve (19.67 %) patients developed lymphoedema of the arm. Hospitalization period was 7 bed-days in 90.0 % of cases. The flap viability reached 100.0 %. In 54 (88.53 %) of 61 patients, the active function of the arm recovered. Thirty-eight (62 %) patients had ECOG 1 status 3 years after surgery.Conclusion. The flap made it possible to solve the local problems of covering the axillary neurovascular bundle during lymphadenectomy for breast cancer and eliminating a large axillary fossa defect. The results obtained demonstrated high engraftment rates with a small number of complications, regardless of the surgery extent.