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Biomedical subjects

A I Pirogov

Publications and source records attributed to A I Pirogov.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Successive radiation and surgical treatment of esophageal cancer.

On the basis of our extensive experience with radiation therapy, surgery, and combined therapy in the treatment of esophageal cancer, we substantiate a basis for giving irradiation followed by surgery. With the high efficacy of radiotherapy (RT), achieving tumor regression of more than 75% with a dose 40-50 Gy, it is expedient to continue RT using a radical programme. This may lead to full recovery without any surgical intervention. However, these patients must be followed-up. If tumor growth continues or if there appears a recurrence of tumor later, a radical operation must be performed (56 clinical cases). During the operation, extirpation of the esophagus with esophagoplasty, or its resection with a one-staged reconstruction with the gastrointestinal tract, is possible. The latter is preferred, as it not only increases the patients' life-span with comparatively low operative mortality, but results in full recovery of some patients.

Adult↗
PubMedDate not supplied

[Preoperative diagnosis of residual tumor in esophageal cancer following radiation therapy].

The authors analyse 100 operations for resection of the esophagus after radiotherapy. Morphological examination before irradiation showed squamous cell carcinoma in all patients. Difficulties arise in the diagnosis of a residual esophageal tumor after radiotherapy, as a result of which 11 (14.5%) of 76 patients irradiated with a dose of 30-40 GY and 1 (4.2%) of 24 patients who received a dose of 50-70 Gy were exposed to the risk of a surgical intervention in the absence of morphological signs of a tumor in the removed esophagus. The difficulties of the diagnosis are due to resorption of the tumor under the effect of radiotherapy, its exophytic component in particular, the frequent submucosal position of the tumor, signs of therapeutic pathomorphosis of the tumor, and fibrosis of the esophageal wall.

Biopsy↗
PubMedDate not supplied

[The highest permissible levels of resection of the esophagus in cancer during surgery with intrathoracic or cervical esophagogastric anastomoses].

The levels of esophageal resection for squamous carcinoma were determined in 84 patients by measuring the distance from the incisors to the ring of the esophagogastric anastomosis during esophagoscopy. The radicalism of the operations was evaluated from the difference in the distance between the incisors and the upper border of the tumor and the distance between the incisors and the anastomosis. The mean levels of the highest possible resections of the esophagus were at a distance of 33.5 +/- 2.8, 23.6 +/- 2.0, and 20.4 +/- 2.0 cm from the incisors, respectively, in Garlock's operation, Lewis' operation, and Dobromyslov-Torek's operation with esophagoplasty using an antiperistaltic gastric pedicle. It is suggested that the choice of the method of surgical treatment should be based on comparison of the determined levels of the highest possible resection of the esophagus with the endoscopic assessment of the level of the upper border of the tumor in the esophagus.

Anastomosis, Surgical↗