APEUTIC AND TACTICAL APPROACHES I N ACUTE COMPLICATIONS OF MALIGNANT STOMACH TUMORS

Abstract

The aim of the research was combines the concept of combating complications of malignant tumors of the stomach and their consequences with a radical treatment process, defined by oncological standards.
 Materials and methods. The study included 766 patients with acute complications of malignant gastric tumors who were treated at the Kyiv city Center for gastrointestinal bleeding from 2006 to 2020. Among patients, 754 (98,4 %) were treated for malignant gastric tumors complicated by bleeding, 12 (1,6 %) were treated for perforated tumors.
 Results and discussion. A total of 361 of 766 patients underwent surgery in the two study periods, with a total operative activity of 47,0 %. Radical surgical interventions in the first period were urgently performed 40 (51,9 %), in the second period — 12 (15,6 %), non-radical in the first period — 37 (48,1 %), in the second — 10 (13,0 %). Early-delayed radical surgical interventions in the first period were performed 75 (26,4 %) patients, in the second — 145 (51,0 %), early-delayed non-radical: in the first period — 26 (9,2 %), in the second — 38 (13,4 %). Thus, we received an increase of almost 30,0 % in the second period of surgical interventions performed in the early deferred period and, as a result, a statistically significant (p˂0,05) increase in the number of radical surgical interventions in the second period (almost twice — up to 70,7 %). The total postoperative mortality was 6,1 % and statistically significantly (p˂0,05) decreased twice in the second period, compared with the first — 8,3 % and 4,4 %, respectively.
 Conclusions. The frequency of emergency surgeries has been reduced by almost 2 times, and early deferred surgery (almost 80,0 %) has increased the proportion of radical surgeries to 70,7 % with D2 lymph node dissection by all cancer standards in 72,0 % of cases.