The advanced purulent peritonitis is one of the urgent problems in urgent surgery. The improvement of surgical research methods is one of important problem of nowadays surgery. The article presents a clinical case of effective treatment of peritonitis, abdominal sepsis in the context of ileotransverse anastomosis failure. Female patient with generalized fibrinous purulent peritonitis underwent surgical interventions using VAC system, damage control tactics. 

Resection of “difficult” polyps is associated with high risks of intra- and postoperative complications. About 10 % of polyps are not amenable to endoscopic resection due to technical difficulties. Routinely, for the treatment of big size laterally spread tumors and early tumor of bowel segmental resections is used, which had a significantly higher risks of postoperative complications development. Hybrid laparoendoscopic surgery included a combination of laparoscopic and endoscopic technologies becomes a great opportunity to local bowel resection. This surgical procedure is accompanied by a minimal risk frequency of postoperative complications and the length of stay. In the two clinical cases we demonstrate techniques of hybrid laparoendoscopic surgery for “difficult” endoscopically unresectable polyps of the colon.

Serrated lesions, as a rule, were considered benign and were likened to hyperplastic polyps by anatomists and gastroenterologists. These views persisted until about 2010. However, recent data showed that serrated lesions can potentially transform into colorectal cancer (CRC). The World Health Organization classification identifies 4 categories of serrated lesions: hyperplastic polyps, sessile serrated lesions, traditional serrated adenoma and unclassified serrated adenomas. Sessile serrated lesions with dysplasia and traditional serrated adenomas are the most common precursors of CRC. Development of CRC from serrated lesions occurs through two different molecular pathways, namely, sporadic microsatellite instability and CpG island methylator phenotype, and the latter is considered the main mechanism inactivating serrated CRC pathway. In contrast to adenoma–carcinoma pathway, APC-inactivating mutations are rare in serrated adenomas.

Severe chronic pain syndrome with high requirement for opioids is frequently complicated by opioid tolerance, hyperalgesia, and other side effects. Special complications occur during anesthesia for high-injury surgical interventions and in the postoperative period. Perioperative pain management in these patients requires planning, multimodal approach, combination methods, and prevention of complications including specific complications. This article describes a case of successful surgical treatment of pancreatic cancer in a patient with severe chronic pain syndrome, opioid tolerance, and hyperalgesia. Perioperative period was complicated by high requirement for epidural pain management and use of adjuvants, acute strangulating intestinal obstruction on day 6 of the postoperative period. The authors had to differentiate between pain syndrome and abstinence multiple times and encountered the problem of tachyphylaxis to local anesthetics. Due to thought-out and flexible system of combination multimodal pain management, pain syndrome was relieved, and the patient was discharged in satisfactory condition without the need for opioids.

This article presents the experience of successful use of immunotherapy in treatment of locally advanced inoperable squamous cell carcinoma of the hairy part of the head.

Follicular lymphoma (FL) is the most common indolent form of lymphoma and characterized by recurrent course and heterogenous clinical signs. Selection of treatment program for patients with newly diagnosed or recurrent FL is based primarily on the size of the tumor. While use of rituximab-containing regimens led to increased progression-free survival, in some cases tumors are refractory to rituximab. Understanding of molecular mechanisms of FL pathogenesis and action of anti-CD20 monoclonal antibodies allowed to develop new drugs with several advantages compared to rituximab. According to the data of large randomized trials, use of glycoengineered monoclonal anti-CD20 type II antibody obinutuzumab in combination with chemotherapy in patients with FL has manageable toxicity profile and longer progression-free survival and event-free survival compared to use of rituximab.

Use of microinfusion elastomeric pumps for extended administration of antitumor drugs improves patients’ quality of life during prolonged cyclic treatment because of the absence of venous complications and infusion allergic reactions during administration of cytostatic agents and targeted drugs.

Anemia is one of the most frequent manifestations of oncological diseases and complications of cytotoxic chemotherapy. Development of this symptom is directly associated with decreased quality of life and possible stimulation of neoangiogenesis, increased tumor aggressiveness and decreased tumor sensitivity to chemotherapy and radiation. Current clinical trial data show decreased overall survival of patients with anemia. Modern methods of anemia correction in oncological diseases include exchange transfusion and administration of recombinant erythropoietins. Transfusion of erythrocyte-containing blood components allow to quickly replenish hemoglobin level, however there is risk of complications. A significant disadvantage of this method is short duration of the effect. Use of erythropoietins allows to reliably increase hemoglobin levels in 60–70 % of oncological patients with long-term effect. In recent years, use of erythropoietins in patients with oncological diseases became a topic of discussion due to possible negative effect on tumor through stimulation of erythropoietin receptors on neoplastic cells. This discussion led to recommendation of using erythropoietins only during chemotherapy in minimal doses.