STAGED TREATMENT OF COLORECTAL CANCER COMPLICATED BY OBSTRUCTIVE ILEUS

Abstract

Aim: Develop and implement stage cancer treatment in the standards of surgical care for the malignant colonic obstruction in Moscow Methods: 572 patients diagnosed with malignant colonic obstruction were reviewed: 247 patients of them were hospitalized in 2011-2013 (I group); 325 - in 2014-2017 (II). 46 patients were treated with non-surgical therapy; 302 - underwent acute resection; 141 - stoma construction; 83 - placement of stents. 110 patients (II group) after 0,5-6 months underwent plan resection and radiation or chemotherapy. Acute resection more frequent was performed in I group, plan resection - in II. The comparative analysis of the nearest and long-term results of treatment in two groups is carried out. The 3-year cumulative survival was also plotted on a Kaplan-Meier chart. Stage treatment is implemented in the standards of surgical care for cancer patients in Moscow. The dynamics of postoperative complications in Moscow from 2014 to 2018 is estimated. Results: Complications occurred in 46,69% (I group) and 21% (II). Postoperative mortality was significantly higher in I group compared with II group: 26,11% and 10,33%, respectively. The survival rate was higher in I group than in II group: 0,82 and 0,69, respectively. The result was a decrease in postoperative mortality in Moscow from 22.4% to 10%. Conclusion: The expediency of application of the new surgical standard is confirmed. A bridging strategy may be a valid alternative in some of patients with malignant colonic obstruction, because a significantly lower postoperative mortality rate.