Medicina v Kuzbasse (Feb 2019)
LAPAROSTOMY IN THE OUTCOME OF PLANNED COMBINED OPERATIONS IN PATIENTS WITH GASTRIC CANCER
Abstract
Subject of research (observation). The need for patients with gastric cancer extensive combined operations in the volume of multi-organ resections is dictated by the prevalence of pathological processes and associated intra-abdominal complications. However, the percentage of complications in such surgical interventions, including those leading to fatal outcomes, reaches 60 %. One of the options that improve the results of combined operations in gastric cancer may be the formation of a laparostomy in the outcome of the primary operation. Objectives – to determine the role of laparostomy in combined operations in patients with gastric cancer. Research methods. In a single-center study, an analysis was made of the treatment of 31 patients who underwent combined surgeries for stomach cancer. Patients are stratified according to the method of completion of the primary operation – with the formation of a laparostomy (8 patients) and without the formation of a laparostomy (23 patients). The criteria for evaluating the results were the number of postoperative complications, the duration of surgical intervention, postoperative bed-day. Results. There were no deaths in this group of patients. The reasons for the formation of laparostomy were: multiple damage to the serous membrane of the small and large intestine, contamination of the abdominal cavity, impaired blood supply and the possibility of necrosis of the stomach stump. In one observation, a laparostoma was performed on an emergency basis due to the failure of the esophago-intestinal anastomosis, which was widespread peritonitis on the 6th day after combined gastrectomy. Postoperative complications in the group of patients with laparostomy formation developed in 3 out of 8, in the group of patients without forming laparostomy in 10 out of 23. There were no statistically significant differences in the groups regarding duration of the surgery, intraoperative blood loss, the duration of stay in the intensive care unit and the total inpatient stay.
