Aim . To improve the efficiency of treatment of advanced liver alveococcosis using modern surgical techniques including transplantation. Material and Methods. It was analyzed surgical treatment of 25 patients with advanced liver alveococcosis for the period 2008–2014. Operations were performed in 21 cases. Lung metastasis were diagnosed in two of them. Long-term obstructive jaundice was observed in 5, portal hypertension – in 2. 1 patient with associated HBV had liver cirrhosis. Results . Surgical interventions had extended volume and included liver resection “in situ” in 16 cases, orthotopic liver transplantation (OLT) in 3 patients. Invasion into IVC was detected in 9 cases. In 6 patients IVA was made a prosthetic appliance using PTFE-prosthesis including 1 case with left hepatic vein orifice repair and 3 cases with partial resection. Resection and reconstruction of portal vein were required in 6 cases. 9 patients underwent resection of the extrahepatic bile ducts. Resection of the right dome of the diaphragm was made in 4 cases. In one case explorative laparotomy was performed. All patients after surgery receive antiparasitic therapy. There was 1 death in the early postoperative period due to multiple organ failure. There were no recurrences within 7-year follow-up. Antiparasitic therapy after liver transplantation did not require adjustment of immunosuppressive therapy. Conclusion . Surgical interventions for liver alveococcosis have advanced volume and are combined with reconstruction of great vessels and bile ducts. Maximum tendency to resection is caused by potential risk of immunosuppressive therapy after transplantation for the progression of the disease, that justifies difficult resections “ex situ”.

The aim of the investigation is to estimate shortand long-term results of the treatment of ductal adenocarcinoma of the head of pancreas after conventional and extensive pancreatoduodenal resection. Materials and methods. There were performed total 27 conventional and 27 extensive interventions. The groups under study were comparable by sex, age, and the degree of tumour differentiation. Mean time of surgery, the volume of blood loss and hemotransfusion, the frequency of postoperative complications, and mortality did not differ significantly. Results. After extensive pancreatoduodenal resection, local recurrence occurred significantly more rarely (7.4 versus 33.3% after conventional surgery). Broadened lymphadenectomy in ductal adenocarcinoma of the head of pancreas did not lead to the increase of postoperative complications, mortality and overall survival. In the meantime, extensive gastropancreatoduodenoal resection enables to decrease significantly recurrence rate.

: Results of treatment of 32 patients after nephrectomy with thrombectomy for renal cell carci-noma complicated by tumor thrombosis of the inferior vena cava were analyzed. The study in-cluded patients only with II - IV clot levels: 26 patients with T3b - the length of the thrombus 5.1 +/- 1.75 cm, 6 patients with T3c - the length of a thrombus - 14.8 +/- 0.98 cm. One patient (3.1%) died due to pulmonary artery thromboembolia in immediate postoperative period. 1-2 degrees Clavier Complications were observed in 11 patients, 3-4 degree - in two (6.2%) patients. 90.4% of patients had metastases in distant organs and (or) in the regional lymph nodes, which nega-tively affected the survival rates of patients - 5-year survival rate was 36%. The presence of lymphogenous metastases, MSKCC criteria were factors affecting survival rate. Survival rates of patients with T3b and T3C levels were not statistically different. The results of postoperative systemic targeted therapy were significantly statistically better than the results of immunotherapy.

The aim of the investigation is to estimate short-and long-term results of the treatment of ductal adenocarcinoma of the head of pancreas after conventional and extensive pancreatoduodenal resection.Materials and methods. There were performed total 27 conventional and 27 extensive interventions. The groups under study were comparable by sex, age, and the degree of tumour differentiation. Mean time of surgery, the volume of blood loss and hemotransfusion, the frequency of postoperative complications, and mortality did not differ significantly.Results. After extensive pancreatoduodenal resection, local recurrence occurred significantly more rarely (7.4 versus 33.3% after conventional surgery). Broadened lymphadenectomy in ductal adenocarcinoma of the head of pancreas did not lead to the increase of postoperative complications, mortality and overall survival. In the meantime, extensive gastropancreatoduodenoal resection enables to decrease significantly recurrence rate.