The work is devoted to the development and improvement of the results of treatment of patients with CRC with colonic obstruction by increasing the efficiency of diagnosis, pathogenetic treatment and predicting the course of the disease on the basis of a comprehensive study and assessment of the level of endogenous intoxication. The work was performed on the basis of complex clinical-laboratory and instrumental examination and treatment of 106 patients with colorectal cancer, complicated obstructive obstruction of the colon. The patients were divided into two groups: the main one, which included 52 patients, and a comparison group consisting of 54 patients. The main group of patients was used algorithm of surgical tactics, based on the criteria of the severity of endogenous intoxication and the implementation of developed and improved methods of diagnosis, conservative therapy and surgical treatment with predominant use in the initial stage of non invasive endoscopic interventions. In the comparison group, commonly used criteria for the definition of surgical tactics and the use of conservative therapy and surgical treatment were used in the treatment. Based on the main clinical indicators, including gender, age, anamnesis, etc., the patients in the main group and the comparison group could be compared, indicating the representativeness of the groups and their studies. The substantiation of metabolic criteria for the inconsistency of postoperative anastomoses made it possible to identify risk groups among patients with CRC and to develop an algorithm for conservative and operative treatment of obstructive colonic obstruction, depending on the degree of severity-compensated, subcompensated, decompensated. The results of the integrated study of changes in the metabolic rate of the protein, lipid, mineral, hormonal, intestinal microbiocenosis and endogenous intoxication levels in patients with chronic obstructive pulmonary obstruction are described in order to determine the severity of the disease, the risks of development of postoperative complications and the choice of surgical tactics. The advantages of using endoscopic methods of correction of acute obstructive obstruction of the colon, such as transoral enteroscopy with concurrent endoscopic lavage of the small intestine and endoscopic stenting of the tumor stricture zone, are presented. As a result of the study, an approach to the selection of methods for diagnosing and treating patients with colorectal cancer complicated by obstruction was developed, taking into account the severity of endogenous intoxication, allowed a reduction in the frequency of ostomy surgical interventions by 6 times in the main group compared to the comparison group, to reduce the incidence of postoperative complications by 12.3% and postoperative lethality - by 17.6%.
