Abstract
OBJECTIVE. The authors investigated the peculiarities and character of complications in gerontological patients with disseminated forms of colon cancer after combined and extended operative interventions. MATERIALS AND METHODS. A retrospective analysis of treatment results of 154 patients was made. The single-stage combined operations were performed on 32 patients of the first group with IV stage of colon cancer. The operation included removing of primary tumor and liver metastases. Combined and extended operative interventions were carried out on 122 patients of the second group with locally-advanced colorectal cancer (T3-4N1-3M0). The patients of both groups were divided into 2 subgroups according to the age: subgroup A - over 60 years of age, subgroup B - younger than 60. Comparison of parameters of postoperative period was made separately in each group between subgroups. RESULTS. There weren’t noted any reliable increase in rate of surgical complication in patients of elderly and senile age with disseminated forms of colon cancer after combined operations. These operations accompanied by high risk of development of functionally-somatic complications as a rule connected with decompensation of concurrent pathology. CONCLUSIONS. The authors recommend to make the careful assessment of general somatic status of gerontological patients with disseminated forms of colorectal cancer and apply the multidiscipline approach in order to balance on time the concurrent pathology after combined operations.
Highlights
The single-stage combined operations were performed on 32 patients of the first group with IV stage of colon cancer
The operation included removing of primary tumor and liver metastases
There weren’t noted any reliable increase in rate of surgical complication in patients of elderly and senile age with disseminated forms of colon cancer after combined operations. These operations accompanied by high risk of development of functionally-somatic complications as a rule connected with decompensation of concurrent pathology
Summary
Изучить особенности и характер осложнений у геронтологических больных с распространенными формами рака толстой кишки после выполнения им комбинированных и расширенных оперативных вмешательств. 1-ю группу составили 32 больных с IV стадией рака толстой кишки, которым были выполнены одномоментные комбинированные операции — удаление первичной опухоли и метастазов в печени. В связи с этим изучение особенностей течения ближайшего послеоперационного периода у пациентов старших возрастных групп после выполнения им комбинированных и расширенных операций имеет важное значение для улучшения результатов их лечения. Цель работы — изучить особенности и характер осложнений у геронтологических больных с распространенными формами рака толстой кишки после выполнения им комбинированных и расширенных оперативных вмешательств. Среди больных с метастатическим КРР (1-я группа) не было прослежено статистически достоверной разницы между возрастными подгруппами по таким параметрам, как распространенность первичной опухоли, число и размер метастазов в печени, поражение регионарных лимфатических узлов, осложнения опухолевого процесса. Годы Локализация опухоли: прямая кишка сигмовидная кишка селезеночный изгиб печеночный изгиб восходящая ободочная кишка слепая кишка Паратуморальные осложнения: нарушение проходимости кровотечение воспаление абсцесс опухолевый свищ интоксикация распад опухоли Регионарные метастазы Физический статус по шкале ASA: II III IV
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