Vol 5, No 1 (2015)

Presented article is a review of domestic and foreign literature on the application of radiomodifying drugs with electron-affinic properties (metronidazole and its derivatives) with the aim of increasing the effectiveness of radiation therapy. The mechanism of action and properties of the electron-affinic drugs of is described. Special attention is paid to the creation of a new medicinal form of metronidazole with the hydrogel-based biopolymer and its inclusion in combined treatment of resectable and locally advanced rectal cancer.

 Analysis of latest trials, comparing treatment schemes including chemotherapy with anti-EGFR monoclonal antibodies or bevacizumab is presented in this article. The data in these trials is inconsistent, but detailed analysis of FIRE-3 trial allows to distinguish a wild-type RAS patient group that benefits most from chemotherapy with cetuximab or panitumumab as 1st line metastatic colorectal cancer treatment. A final analysis of this patient group in CALGB/SWOG 80 405 trial is pending. The RAS analysis is pivotal for choice of 1st line chemotherapy.

Aim. Examination of efficacy of the double-lumen “pipe in pipe” drainage set mounted in the cavity of the lesser pelvis by the method developed by the authors for conservative treatment of colorectal anastomotic leak.

Material and methods. Data have been analyzed for 124 patients operated in two surgeries of the base No.2 of the Republican Clinical Onco- logic Dispensary of the Ministry of Health of the Republic of Tatarstan, whose surgery was completed with formation of colorectal anastomo- sis; aspirating drainage of the cavity of the lesser pelvis was performed with double-lumen drainage of the authors’ design, mounted in the retroperitoneal part of the cavity of the lesser pelvis through a puncture in the anterior abdominal wall. No patient was applied a preventive intestinal stoma.

Results. 4 (3.2 %) out of 124 patients died after surgeries. 21 (16.9 %) patients experienced colorectal anastomotic leak, which was resolved in a conservative manner in all patients.

Conclusion. Our data allow us to speak about the efficacy of this technique of drainage of the cavity of the lesser pelvis in colorectal anastomotic leak.

Long-term results of conservative squamous-cell rectal cancer treatment (12 cm above anal verge) are presented in the article. Squamous-cell rectal cancer is a rare disease with only 73 cases described in the literature. Patient received a novel chemoradiotherapy scheme. Complete response was achieved and no surgery performed. Patient is disease-free and has good quality of life with 4 years followup.