ANATOMICAL-TOPOGRAPHICAL STUDY SELECTION HTIRURGICHESKOGO ACCESS ADRENALS AT ADRENOCORTICAL CANCER
The spatial conditions of different surgical approaches to the adrenal glands, the central vein, and aortocaval gap with the constitutional features of the human body. Significant differences in syntopy and skletotopy adrenal depending on body types, which is reflected in the parameter has surgical approaches. When abdominotorakofrenotomy greatest angle of operation of the detected in asthenics, the lowest - in hypersthenics. Subcostal laparotomy shows an inverse relationship - the largest angle of operation of the observed at hypersthenics, respectively lowest in individuals asthenic body type, and the average position occupied normosthenics. Midline laparotomy in the classic version on all counts inferior to the two previous methods, and the dependence of similar to hypochondria laparotomy. The best spatial parameters only to the adrenal gland obtained at torakofrenolyumbotomy, due to the shortest distance from the edges of the wound to cancer. But it showed the worst options available to aorto-caval gap, where explicit leadership belongs modified laparotomy with mobilization of the right lobe of the liver and peritoneum-retroperitoneum access.