Staged approach in the surgical treatment of patients with obturation obstruction of the colon of blastomatous genesis ; Етапный подход в хирургическом лечении больных с обтурационной непроходимостью толстой кишки бластоматозного генеза ; Етапний підхід у хірургічному лікуванні хворих з обтураційною непрохідністю товстої кишки бластоматозного генезу

The aim of the work: to improve the results of surgical treatment of patients with obturation obstruction of the large intestine of the blastomatous genesis by improving the algorithm of therapeutic and diagnostic tactics. Materials and Methods. For the period of 2009–2018 127 patients with obturation obstruction of the large intestine of tumor genesis were treated in the Surgical Clinic of Kyiv City Clinical Hospital No. 3, which is 5.1 % (2485 patients) of the total number of patients with emergency surgery. There were 66.2 % (84 patients) women, and 33.8 % (43 patients) men. The average age of patients was (68.2±15.4) years. Etiologically, intestinal lumen obturation in 10 (7.9 %) patients was a caecum tumor, in 11 (8.7 %) – the ascending colon, in 5 (3.9%) – hepatic flexure of the colon, in 6 (47 %) – transverse colon, 5 (3.9 %) – splenic flexure of the colon, 18 (14.2 %) – descending colon, 32 patients (25.2 %). The level of the obstruction was localized in the sigmoid colon and in 30 (23.6 %) at the level of the rectum. In addition, in 10 (7.9 %) patients obstruction caused germination of tumors of the uterus, ovaries or bladder in the distal colon. Results and Discussion. The results of treatment of 127 patients with obturation obstruction of the colon of the tumor genesis, who were treated in the surgical clinic of the City Clinical Hospital No. 3 for the period of 2000–2018, are presented. A diagnostic and treatment algorithm was developed for the phasing of surgical care for patients with this pathology. The staged approach and the use of minimally invasive methods of intestinal decompression in the form of stenting, recanalization and insertion of the probe proximal to stenosis increased the percentage of delayed surgical interventions (up to 37.8 %) and reduced mortality by 14 %. ; Цель работы: улучшить результаты хирургического лечения больных с обтурационной непроходимостью толстой кишки бластоматозного генеза путем усовершенствования алгоритма лечебно-диагностической тактики. Материалы и методы. ...