RISK FACTORS OF POSTOPERATIVE COMPLICATIONS DEVELOPMENT IN PATIENTS WITH RECTAL CANCER

Abstract

Rectal cancer remains one of the most pressing problems today. Despite the development of technologies that can stage the disease and the use of modern treatment protocols, there is no continuous linear improvement in patient survival. The various concepts proposed for the treatment of colorectal cancer do not lead to a statistically significant improvement in overall survival. This may be due to the variability of the concepts of rectal cancer treatment, including the choice of a short or long course of neoadjuvant therapy, a standard regimen or total neoadjuvant therapy, surgery or "watch and wait" tactics. The likelihood of developing surgical complications, especially in cases of neoadjuvant treatment, also remains high, despite the development of minimally invasive accesses and the use of suturing devices, which in turn can lead to poor survival, local recurrence, and disability in patients. Understanding different concepts and strategies for treating patients with rectal cancer, systematically assessing various risk factors for postoperative complications, and modifying them individually can improve not only local outcomes but also overall survival of rectal cancer patients. Several studies have shown that the use of neoadjuvant chemotherapy in patients with rectal cancer significantly increases the risk of postoperative complications, although it reduces the likelihood of local and long-term recurrence. Therefore, given that neoadjuvant therapy is usually a mandatory step in treatment, further research should be conducted on the effects of different doses and regimens, and there is an urgent need to study other modified risk factors for postoperative complications, including BMI, stapler use, size stitching circular apparatus and others. Only in-depth study and accumulation of more data will allow you to more effectively choose the right treatment tactics that will increase life expectancy and reduce the disability of patients with rectal cancer. Thus, despite the great advances in understanding the treatment of rectal cancer, the application of the concept of combination therapy and the development of technical equipment, there are still several controversial issues that require detailed study. In particular, this applies to neoadjuvant chemotherapy, and a detailed study of the timing and different courses of radiation therapy, to ensure maximum effectiveness and reduce the risk of complications. This can be achieved only with the use of an individualized approach to the treatment of patients. The aim of the study is to assess the impact of various risk factors for postoperative complications, including anastomotic failure in patients receiving neoadjuvant chemotherapy. A research and analysis of PubMED publications for 2015-2022 has been made, which provided data on the use of neoadjuvant therapy in patients with rectal cancer and assessed risk factors for postoperative complications. The search queries included "rectal cancer", "anastomosis failure", "neoadjuvant therapy", "risk factors", and "survival of rectal cancer patients". Analysis of treatment and postoperative surgical complications in patients with adenocarcinoma of the rectum stage I-III in the Precarpatian clinical oncological centre during 2019-2022 was performed.