Object - acute extensive peritonitis, originated against a background of large intestine cancer; aim - to improve the results of the patients' treatment suffering from acute extensive peritonitis, the nidus of which is complicated cancer of the large intestine, by means of the development and introduction of the therapeutic approach on the basis of the detected clinical-laboratory peculiarities of its clinical course; methods - experimental, biochemical, pathomorphological, microbiological, instrumental, statistical; novelty and results - for the first time acute extensive peritonitis, originated against a background of the malignant neoplasm of the large intestine, has been shown, for the most part, to be general, serous-fibrinous, diagnosed more often in the terminal phase, severity degree III, predominantly in elderly age patients, who in preoperative period have insufficiency of two or more systems of organism, with typical intra-abdominal hypertension and chronic concomitant pathology; first, the model of the large intestine cancer (patent № 98406 from 27.04.2015) has been elaborated by means of implantation of a piece of Guerin's tumor into the large intestine cavity, which enables to get the expected result of cancer in 71,6% of cases in animals under study; for the first time, it has been proved experimentally, that acute extensive peritonitis, originated against a background of the large intestine cancer in comparison with peritonitis of nontumorous genesis, is characterized by the onset of small- nidi centers of central-lobular colliquative necrosis of the hepatic tissue, increase of the per cent of collabular glomeruli of the kidney tissue, veritable predominance of indices of fibrinolytic and proteolytic activity of the peritoneum transaminases, urea, blood serum creatinine, an increase of quantity of the sowed out strains K. pneumoniae, Proteus microorganisms, Candida, appearance of S. aureus growth, as well as increase of the population level of E. coli, K. pneumoniae, Proteus and Streptococcus microorganisms, Candida on the 48th hour of observation; first it has been determined that acute extensive peritonitis, originated against a background of the large intestine cancer, is characterized with credible prevalence of fibrinolytic and proteolytic peritoneum activity, as well as concentration of the medium-molecular peptides of the blood plasma, in comparison with peritonitis of non-tumorous etiology; for the first time pathomorphological peculiarities of acute extensive peritonitis of oncological genesis, which is characterized by a distinct edema of the hepatic and renal tissue, glomeruli collapse and stasis of microcirculatory bloodstream of the renal tissue as well as accumulation of edematous fluid with a large quantity of erythrocytes in the respiratory parts of pulmonary tissue, absence of hyaline membranes have been revealed; first it has been established that the highest concentration of medium-molecular peptides of the blood plasma is marked in patients with acute extensive peritonitis of oncological genesis, characterized by severity degree III, according to Manheim peritonitis index, accompanied by organic dysfunction of more than three organs and intra-abdominal hypertension III-IV degree; the algorithm of medical tactics in case of acute widespread peritonitis of oncologic genesis is developed, which includes application of a scale for the selection of a rational method of closing the abdominal cavity, determination of the optimal duration of a programmed laparapertion, the use of which allowed to reduce the number of "local" postoperative complications by 25.7%, "systemic"- by 23,3%, postoperative lethality - by 20,8% and to reduce the average bed-day by 1,22 times;the results of the work have been introduced into practice and used in the work of MCE "Emergency hospital", Chernivtsi, OCE "Chernivtsi oblast clinical hospital", OCE "Khmelnytsk oblast hospital", Khmelnytsk oblast oncologic dispensary" as well as central regional hospitals of Letychiv, Derazhniansk, Yarmolyntsi, Starokostiantynivsk, Krasyliv, Khmelnytsk oblast, in educational process at the departments of oncology and radiology, surgery, surgery and urology, general surgery of HSEE of Ukraine "Bukovinian State Medical University", at the department of general surgery of HSEE of Ukraine "Ternopil State Medical University named after I. Ya. Horbachevsky"; branch of appliance - therapy process of the divisions of surgery and oncological surgery, as well as educational process at the departments of surgical direction of medical educational establishments.
