Historically, colorectal surgeons extended lymph nodes dissection level. However, it is still controversial issues: what is considered to be an extended lymph node dissection, why and to whom it is better to do it, etc. Moreover, the prognostic value of extended lymph dissection was demonstrated in trials with a low level of evidence and has different degrees of recommendation in different countries and regions. On one hand positive apical lymph nodes in colon cancer achieves 17 % and its risk increasing with tumor penetration into bowel wall, and it is an independent negative prognostic factor with 5 years overall surveillance less 45 %. An indirect data (increased the number of lymph nodes, integrity of removed mesocolon, lymphovascular length, etc.) showed better outcomes with extended lymph node dissection. More controversy is extended lymph node dissection for rectal cancer, the current standard of treatment which is at chemoradiotherapy and/or total mesorectumectomy for T3–4N0–2. Because there is no evidence that lateral pelvic node dissection in rectal cancer improves disease-free survival and overall survival, as well as high ligation of the inferior mesenteric artery. And the presence of pelvic and inferior mesenteric lymph node metastases, identifying average in 7 %, is associated with a high level of local recurrences till 44 % and low survival rate not more 42 % in 5 years. The answer to this question may be conducting multicenter randomized trials. 

Research objective. To prove experimentally the possibility of forming a compression colonic anastomoses using nickel-titanium devices in comparison with traditional methods of anastomosis.
Materials and methods. In experimental studies the quality of the compression anastomosis of the colon in comparison with sutured and stapled anastomoses was performed. There were three experimental groups in mongrel dogs formed: in the 1st series (n = 30) compression anastomoses nickel-titanium implants were formed; in the 2nd (n = 25) – circular stapling anastomoses; in the 3rd (n = 25) – ligature way to Mateshuk– Lambert. In the experiment the physical durability, elasticity, and biological tightness, morphogenesis colonic anastomoses were studied.
Results. Optimal sizes of compression devices are 32 × 18 and 28 × 15 mm with a wire diameter of 2.2 mm, the force of winding compression was 740 ± 180 g/mm2. Compression suture has a higher physical durability compared to stapled (W = –33.0; p < 0.05) and sutured (W = –28.0; p < 0.05), higher elasticity (p < 0.05) in all terms of tests and biological tightness since 3 days (p < 0.001) after surgery. The regularities of morphogenesis colonic anastomoses allocated by 4 periods of the regeneration of intestinal suture. 
Conclusion. Obtained experimental data of the use of compression anastomosis of the colon by the nickel-titanium devices are the convincing arguments for their clinical application. 

Objective: to study the immediate results of laparoscopic intersphincteric resection (ISR) and ultralow anterior resection (ULAR) of the rectum.
Subjects and methods. The results of surgical treatment in 42 patients operated on in the Saint Petersburg Clinical Research-Practical Center for Specialized Medical (Oncology) Cares in March 2014 to January 2015 are given. The inclusion criteria were the lower edge of cT1–3N0 adenocarcinoma 2-5 cm above the dentate line and no signs of invasion into the sphincter and levators. All the patients were divided into 2 groups: 1) 24 patients who had undergone laparoscopic ISR; 2) 18 patients who had laparoscopic ULAR. Both groups were matched for gender, age, body mass index, and CR-POSSUM predicted mortality scores. Thirty-two patients received neoadjuvant chemoradiotherapy.
Results. The mean duration of operations did not differ significantly in the groups: 206 ± 46 and 216 ± 24 min (р = 0.72). The differences in the mean volume of blood loss were also insignificant: 85 and 113 ml (р = 0.93). Circular and distal resection margins were intact in all the cases. In 18 (75 %) patients in Group 1 and in 14 (77.8 %) patients in Group 2, the quality of total mesorectumectomy (TME) was rated as grade 3 according to the Quirk criteria (p = 0.83). In Group 1, complications requiring no reoperation occurred in 5 (20.8 %) cases: anastomotic incompetence in 3 (12.5 %) cases, anastomotic stricture with further bougienage in 1 (4.2 %), and urinary retention in 1 (4.2 %). In Group 2, postoperative coтplications were also observed in 5 (27.8 %) cases: necrosis of the brought-out bowel in 2 (11.1 %) patients and coloanal incompetence in 1 (5.6 %) required reoperation; 2 (11.1 %) patients underwent bougienage due to established anastomotic stricture. One month postoperatively, the Wexner constipation scoring system was used to rate the degree of encopresis: anal incontinence turned out to be significantly higher in Group 2 and amounted to 9.3 versus 6.2 in Group1. ULAR required consumables costing an average of 45 000 rubles more than did ISR. 
Conclusion. Both surgical procedures are comparable in the duration of a surgical intervention, the volume of intraoperative blood loss, and the quality of TME. ULAR with a reservoir is functionally more preferential. 

Objective: to make the language adaptation and testing of an EORTC QLQ PRT-23 module, a method to assess quality of life, which has been elaborated in conjunction with the European organization for research and treatment of cancer quality of life questionnaire group (EORTC QLQ group), in clinical practice.
Subjects and methods. An initiative study of the language adaptation of the EORTC QLQ PRT-23 module was completed. The elaborated questionnaire was tested in clinical practice. The criteria for including patients (n = 176) in the study were successful radical antitumor therapy; at least three months’ duration of small pelvic radiotherapy (RT); clinical Stage 0–IV according to the Radiation Therapy Oncology Group (RTOG) and EORTC; and endoscopically verified signs of developed radiation-induced rectitis (Stages 0–IV after M.S. Bardychev); no recurrence of the underlying disease throughout the follow-up; patient compliance; availability of a patient to be followed. Results. The range of performed RT in the patients included in the study protocol was as follows: 61 (34.6 %) patients had a total focal dose of RT, which was not higher than the tolerance values for the rectal mucosa (from 60 to 70 Gy); 115 (65.4 %) patients had a radiation dose range of 70 to 80 Gy. At least 3 months passed from the completion of the given RT to the study inclusion. 
With the EORTC QLQ PRT-23 module, the differences between RTOG/EORTC 0 and RTOG/EORTC II–IV groups were as follows: p0–II < 0.02, p0–III < 0.0001, and p0–IV < 0.0006. When the EORTC QLQ С-30 and QLQ PRT-23 in RTOG/EORTC III group (n = 7) and the RTOG/EORTC 0 group, this was p0–III < 0.002.
Assessment of the QLQ С-30 and QLQ PRT-23 modules and comparison of patients with RTOG/EORTC Stages I, II, and IV and those with RTOG/EORTC stage 0 revealed no statistically significant group difference: p0–I < 0.81, p0–II < 0.07, and p0–IV < 0.07, respectively. 
The use of the QLQ PRT-23 module only yielded significantly different results between the patients without chronic radiation-induced rectitis (Stage 0) and those with the endoscopic manifestations of Stages III and IV radiation-induced rectitis (p0–III < 0.0006; p0–IV < 0.0004). The values of the EORTC QLQ С-30 and QLQ PRT-23 questionnaires were statistically significantly different in the patients with endoscopically verified radiation-induced rectitis and in those without this condition (p0–I < 0.03; p0–II < 0.02; p0–III < 0.0016; p0–IV < 0.00009). 
Conclusion. The EORTC QLQ С-30 and QLQ PRT-23 questionnaires may be used in the patients with chronic radiation-induced rectitis for assessment of the quality-of-life index, for determination of the integral values over time (before, during, and after treatment), for informed involvement of a patient during treatment, for estimation of patient satisfaction with the therapy performed. The EORTC QLQ С-30 questionnaire supplemented by the QLQ PRT-23 module is a subjective method. Our study provided support for the fact that the QLQ С-30 and QLQ PRT-23 questionnaires for staging chronic radiation-induced rectitis must be used in combination with any third questionnaire. 

Surgery is the only potentially radical treatment option for locally advanced and recurrent rectal tumors invading the sacral vertebrae. However, the choice of tactics for this patient category remains a difficult task. In spite of the fact that chemoradiation therapy yields good results, it is very difficult to differentiate postradiation changes and residual tumor; the immediate results of combined surgical interventions accompanied by sacral resection remain unsatisfactory, which restricts their use in routine practice and the frequency of unradical operations and local recurrences remains high. 
Optimization of the results of abdominosacral resection in patients with rectal cancer requires that the definite principles should be adhered to. The chief task of treatment (radical surgery) is fulfilled via resection of the sacrum and, if indicated, other organs even to the extent of performing total pelvic evisceration. In the present view, radiotherapy is a compulsory component of combined treatment that enhances surgical radicalism. However, its impact on the results of this intervention type has been inadequately studied so far. Careful selection of patients to undergo abdominosacral resection determines high requirements for preoperative tumor imaging techniques. Due to their technical complicacy, it is recommended that this operation should be made only by specialized cancer centers having capacities for performing combined treatment for colorectal cancer. 

Synchronous colonic tumors of different morphology are rarely described in the literature and do not have a clear ethiological connection. This fact is the key to a more detailed study of the clinical and morphological and molecular genetic features of different gistotipov synchronous tumors. There is increasing publications and clinical observations of simultaneous coexistence of adenocarcinoma and gastrointestinal stromal tumor. A separate and very valuable space is given interaction surgeons oncologists and pathologists. Today, for the correct pathological diagnosis of synchronous tumors of different biological nature, it is obligatory to conduct immunohistochemical study. Data on the results of treatment of synchronous tumors must necessarily be recorded in the cancer registries. Based on that, the developed algorithms timely diagnosis and proper treatment strategy in the cohort of patients. We present a case report of a 56 year old patient with a rare synchronous epithelial and non-epithelial colon tumors.