Background. The main reason for urgent complications of colon cancer is an acute intestinal obstruction (AIO). This is complex pathological condition in 90 % of cases caused by colorectal cancer (CRC).
Objective – to evaluate radicality of the performed operations in complicated colorectal cancer in general surgical hospitals. Dependence of the severity of intestinal obstruction by tumor localization, its morphological characteristics, determine dependence of the type of the surgical operation performed on the severity of intestinal obstruction.
Materials and methods. We have studied the data on 667 patients with colorectal cancer complicated by acute intestinal obstruction. These patients were treated in the period from 2001 to 2013 in general surgical hospital in the territory of Smolensk and Smolensk region. For the processing of the obtained results we have used software Statistica 6.1. Differences were considered statistically at p ≤ 0.05.
Results. All the patients were divided into 3 groups by the expression of intestinal obstruction. Group 1 (n = 279) consisted of patients with the presence of decompensated intestinal obstruction (DIO), group 2 (n = 313) consisted of patients with subcompensated intestinal obstruction (SIO), group 3 (n = 75) included patients with compensated intestinal obstruction (CIO). In case of tumor localization in right halfof the colon we most commonly observed clinical picture of acute development of decompensated intestinal obstruction (p = 0.041). Subcompensated intestinal obstruction prevailed in case of tumor localization in left half of the colon and rectal localization. In general surgical hospitals it is not always possible to speak about radicality of surgical treatment, as in a large number of cases (62.5 %) the number of examined lymph nodes was less than 4. When DIO patients are admitted in the clinic, the percentage of singlestage operations is equal to 7.5 % (n = 21). In case of DIO and SIO there was a high percentage of multi-stage operations with removal
of the tumor at the 2nd stage (33.0 and 25.2 %, respectively). DIO most often was noted in case of circular tumor growth (93.5 % of cases). To a lesser extent the severity of acute intestinal obstruction was influenced by such factors as extent of the tumor along the intestinal wall and its histological type.
Conclusion. In the general surgical hospitals final decision on the choice of surgical approach depends on the general condition of patients, surgeon’s experience and hospital where the surgery is performed. It is advisable to carry out surgical interventions in the given contingent of patients in the specialized departments.

Background. The paper presents our own experience of using a waterjet dissector ERBEJET2® in the course of surgical interventions for colorectal cancer. This experience is unique for Russia.
Materials and methods. Waterjet dissection method associated with total  mesorectumectomy was used by us in 20 patients suffering from rectal cancer. An average age of patients was 59.2 ± 13.9 years. In all the patients surgeries were performed for adenogenic colorectal cancer, morphologically verified at the preoperative stage. Resected preparations were studied on morphological level. For comparison, two control groups of 20 patients were selected, in which the rectum mobilization was performed by using monopolar coagulator and harmonic scalpel. The studied groups were matched by gender, age, location and the tumor extent. All the surgeries were performed by one surgical team.
Results. Results of the study demonstrated advantages of waterjet dissection when performing total mesorectumectomy due to a minimum depth of tissue damage on the lateral margin of resection.
Conclusion. Waterjet dissectors have taken their place in the extensive list of tools used when performing surgical interventions for colorectal cancer, that allows to expect an improvement of functional and oncological results of the surgical treatment.

Sufficient length, as well as an adequacy of the blood supply to the distal part of the relegated colon in the formation of primary anastomosis are major intraoperative factors that can reduce the number of anastomotic leak in case of colon resections. Intraoperative fluorescence angiography allows you to assess an adequacy of the blood supply. It is easily feasible and reproducible technique. In this paper we publish our first experience of using this technique in 7 patients. In 1 of them intraoperative surgical tactics was changed after the study. Further developments in this direction are necessary in order to evaluate clinical significance of intraoperative fluorescence angiography in perfusion objectification during surgical operations on the colon.

Objective: to investigate the efficiency of defunctioning stomas in protection of the anastomosis formed during the resection of the colon due to cancer including the complicated colorectal cancer.
Materials and methods. Retrospective analysis of treatment outcomes of patients with a colorectal cancer whom resections of the rectum were performed, treated at the V.A. Oppel Clinic of Hospital Surgery of the North-West I.I. MechnikovState Medical University from 2010 till 2015.
Results. The article presents a retrospective analysis of the results of treatment of 46 patients with colorectal cancer. All the patients underwent a resection of the rectum with the formation of preventive colostoma and without it. The patients were divided into 2 matched by sex, age groups. Resection of the rectum with defunctioning stoma forming due to the complicated colorectal cancer was performed to 3 patients. Complications were found in 6 patients: 2 patients after resection of the rectum with the formation of preventive colostoma and in 4 patients after resection without its formation. Death rate was 4.3 %. 2 patients died, to both patients defunctioning stomas weren’t performed.
Patients with defunctioning stomas stayed in hospital in average for 3 days longer comparing with patients whom defunctioning stoma wasn’t formed. The stoma closure operations were performed to 89.5 % of the patients with defunctioning stomas.
Conclusion. The data demonstrate efficiency of defunctioning stoma in prevention of anastamosis complications in surgical treatment of colorectal cancer including complicated colorectal cancer. However, must be conducted a clear definition of indications for its formation.

Surgical treatment of metastatic colorectal cancer in lungs is a relatively new trend of modern oncology. In this connection, still there are no clearly formulated criteria for patient selection for this type of intervention, approaches to repeated resections and scope of the surgical operation in case of multiple lesions. Established key prognostic factors include lesion of intrathoracic lymph nodes, timing of the development of metastatic disease, baseline level of carcinoembryonic antigen, number of foci and the volume of metastatic lesion, stage of the disease. Options for surgical access include lateral thoracotomy, sternotomy, thoracoscopy and thoracoscopy combined with additional minithoracotomy.
If a patient has a single peripheral metastatic lesions, physician should prefer thoracoscopic operations. One of their advantages include minimum development of adhesions and possibility of subsequent re-thoracoscopy. Resection of pulmonary metastases from colorectal cancer (R0 resection rate) allows to achieve persistent healing of the tumor process in a significant number of patients.

The term “liquid biopsy” describes the study of various tumor derivatives (circulating tumor DNA, circulating tumor cells, tumor RNA, tumor proteins) in the blood plasma. Results of liquid biopsy provide real-time information on the molecular pathologies and morphological
features throughout the whole tumor mass and allow to estimate evolutionary changes of tumor mass in the dynamics, heterogeneity of mass formation and effectiveness of the therapy. Despite the impressive perspective of this method in the diagnosis, monitoring of disease, there is a number of problems for the implementation of liquid biopsy for various cancer pathologies. In this literature review, we focus on the role of circulating DNA as a source of information about the tumor in patients with colon cancer.

This article displays the results of successful combined treatment of patient with recurrence of rectal carcinoma with use of preoperative chemotherapy followed by infralevator pelvic exenteration and primary reconstruction of pelvic floor using xenotransplant “Kollost”.