Purpose of the study. To assess the state of renal function in the application of therapeutic plasmapheresis in order to correct the disorders accompanying the development of preclinical stage of AKI in patients after partial nephrectomy under conditions of warm ischemia.

Patients and methods. We examined 119 patients (average aged 57.6±7.8 years) from 2018 to 2019, who underwent open or laparoscopic kidney resection for cancer according to elective indications and with the usage of standard WIT technique within 15-21 minutes. Patients with a high risk of developing a clinical stage of AKI (n=21) were divided into 2 groups: in group I (n=10), patients continued to receive standard nephroprotective therapy, in group II (n=11), 24 hours after surgery, therapeutic plasmapheresis was performed according to the TPE (Therapeutic plasma exchange) protocol. During 7 days after the surgery patients in both groups were monitored daily for the rate of hourly diuresis, serum creatinine, and creatinine GFR. The presence of significant differences in the groups was evaluated using the STATISTICA 12.6 software package and the differences between the samples were considered significant at p<0.05.

Results. The development of the clinical stage of AKI in group I was detected in 80.0 % of cases, in group II in 9.0 % of patients (p=0.0019). The rate of diuresis in group II was significantly higher: by more than 2 times by day 3, by 90.0 % on day 4, by 81.4 % on day 5, by 36.8 % on day 6, and by 25.4 % on day 7 (p<0.05). The average increase in creatinine in group I was significantly higher: more than 5 times on day 5 and more than 4 times on day 6 and 7 of the study (p<0.05). GFR in group II was significantly higher on day 3 (65.3 %), day 5 (54 %), day 6 (39.2 %) and day 7 (50 %) (p<0.05).

Conclusion. Therapeutic plasmapheresis is highly effective in the correction of renal function disorders after kidney resection under WIT conditions and demonstrates an advantage in reducing the risk of developing a clinical stage of AKI in comparison with preventive measures that include standard nephroprotective infusion therapy.

Surgery for advanced cancer of the oral cavity and oropharynx are among the most difficult. This is due to the topographical and anatomical features that limit the operating field and the proximity of the internal carotid artery, which penetrates into the skull without branches. Her injury and bandaging are fraught with lethality. In the postoperative period, due to a violation of the function of swallowing, there is a stagnation of oral fluid in the oral cavity, which pro[1]motes healing by secondary tension. The functions of the oropharynx are impaired: swallowing, chewing, breathing and speech.

Purpose of the study. To develop an operation in patients with advanced cancer of the oral cavity and oropharynx, allowing to visualize the area of the tumor with it’s radical removal and postoperative healing without suppuration.

Patients and methods. We’ve operated a patient with advanced cancer of the oral cavity and oropharynx with me[1]tastases to the cervical lymph nodes (T4 N1 M0 – IV st.). Cervical lymphodessection and removal of the tumor from the oral cavity and oropharynx was performed according to the method developed at the National Medical Research Centre for Oncology of the Ministry of Health of Russia: the tumor was removed after a preliminary modified mandib-ulotomy. Good visualization allowed for a radical operation, after which a urostoma was formed, which promotes the free flow of oral fluid from the oral cavity, without its stagnation and without suppuration of the tissues. The jaw was restored with two titanium mini-plates.

Results. The healing was carried out by primary tension. On the 7th day after the operation, breathing was restored[1]decanulated. On day 20, epithelialization of the wound surface of the oral cavity and oropharynx occurred. The nasoesophageal probe was removed. Plastic orostoma was produced. By this time, the functions of the oropharyngeal region were partially restored: chewing, swallowing, and speech. Discharged home. Remission for more than 2 years.

Conclusions. Previously performed modifi ed mandibulotomy in patients with advanced cancer of the oral cavity and oropharynx, allows you to expand the view of the operating field and provide a radical operation. The formed orostoma, preventing suppuration in the oral cavity, accelerates healing with the restoration of functions: chewing, swallowing, breathing and speech.

Relevance. Staged orthopedic treatment was used to improve the quality of life of patients who underwent radical maxillofacial surgeries for cancer.

Patients and methods. 197 patients receiving treatment for maxillofacial cancer were observed at the Department of head and neck tumors, National Medical Research Centre for Oncology of the Ministry of Health of Russia, in 1998- 2018. All patients underwent radical surgical treatment resulting in postoperative defects of the upper jaw, soft tissues of the zygomatic- buccal-orbital region, nose, or auricle.

Results. Removable obturator prostheses with various supporting and retaining elements were made for 159 (80.7 %) patients. Individual facial prostheses were made for 38 (19.3 %) patients: 17 (44.7 %) – external orbital prostheses, 14 (36.8 %) – external nasal prostheses, 6 (15.8 %) – external zygomatic- buccal-orbital prostheses, 1 (2.7 %) – external auricle prosthesis. Combined prostheses were made for 4 patients– removable upper jaw obturator and nose prosthe[1]sis; removable upper jaw obturator and eye prosthesis. Combined prostheses were fixed to each other using magnets. The results of maxillofacial prosthetics were evaluated according to the aesthetic requirements of the patients and their quality of life. Maxillofacial prostheses allowed a complete restoration of chewing, swallowing, and speaking, restored facial deformation, and improved the appearance of patients.

Conclusions. Timely and comprehensive orthopedic treatment of patients with postoperative maxillofacial defects after radical surgeries for malignant tumors takes the main place in the complex of rehabilitation measures. Early elimination of extensive defects is aimed at maximum restoration of oral dysfunctions and appearance preservation. The apparent advantages of maxillofacial prostheses involve improvement of social adaptation and the quality of life of patients, which promotes complete rehabilitation and a return to socially useful activities.

With a frequency of 2.2 cases per 100,000 population in Russia, Hodgkin's lymphoma (HL) is one of the most common malignant neoplasms in young people. In connection with the predominant spread of HL among young people, the issue of effective treatment of various forms of HL remains relevant. Currently, 70-90 % of patients with HL who have received standard chemotherapy or chemoradiotherapy have a long period of remission. However, 10 % of patients with progressive course, can`t achieve a response, and 30 % of patients subsequently recur. The standard approach of treating recurrent and/or refractory HL after initial treatment is “salvage therapy” followed by consolidation with high-dose chemotherapy and stem cell transplantation. Although there is a model for treating these patients, recent research has focused on improving the effectiveness and tolerability of rescue therapy. The use of anti- PD-1 drugs opens up new possibilities for the treatment of recurrent/refractory HL. The article describes the results of using checkpoint inhibitors for patients with a history of multi- course chemotherapy. Inhibitors of immune check points were supplemented in the 3rd and subsequent lines of ChT. A clinical case with immunotherapy supplementation in a patient with severe comorbidity is also presented.

The article describes a clinical case of surgical treatment of a patient with multiple primary malignant lesions of the lungs (cancer of the left lung, central peribronchial nodular tumor with involvement of the upper lobe and distal parts of the main bronchus; cancer of the right lung, central tumor with involvement of the upper lobar bronchus). Radical treatment became possible due to using the potential of artifi cial gas exchange of both lungs with two devices with fundamentally different ventilation mechanics. The choice of an optimal tactics for the functional correction of the supposed hypoxemia by volumetric and high-frequency pulmonary ventilation allowed avoiding an imbalance in the ventilation/perfusion ratio and preventing the development of life-threatening complications, as well as ensured an adequate gas exchange for the patient during surgical treatment.

Today, colorectal cancer (CRC) is the third most common cancer and therefore an urgent problem of oncology. Despite all modern diagnostic capabilities, the rates of advanced cases are growing steadily. CRC was proven to be a result of a phased dysplastic change in the colon mucosa, molecular genetic changes that determine the molecular biology of the tumor, its properties, morphology, disease prognosis and response to therapy. The following mechanisms of CRC tumor progression are distinguished: chromosomal instability, microsatellite instability, "methylator" phenotype, and serrated pathway of adenocarcinoma development. Application of molecular and diagnostic methods has become a promising direction in recent years. This led to the development of a molecular genetic classifi cation with 4 CRC subtypes differing not only in their molecular genetic characteristics, but also in clinical course and response to therapy.