Bondar V. Perspectives for development of surgical treatment of patients with cancer of distal part of stomach

Object - patients with distal stomach part cancer. Aim - to raise the life quality of patients with distal stomach part cancer and to improve immediate and distant functional results by means of development and application of new methods of gastrointestinal tract reconstruction. Methods - clinical, morphologic, instrumental (endoscopic, rontgenologic, US, radiologic (radionuclide imaging of stomach), statistic. Newness - first time in clinical practice new methods of gastrojejunoplasty are developed; intraoperative and postoperative complications, postoperational period features and complications evolution causes after usage of worked out methods of operative intervention are analized; functional activity mechanism of gastric remnant in various terms after operation using endoscopy, rontgenography, radionuclide imaging of stomach are studied, their high performance in comparison with the most common gastric resection methods is proved; it is firstly proved, that antireflux mechanism of actively peristaltic intestinal loop, which participates in gastroenteroanastomosis zone isolation from free abdominal cavity is complicated and plural-component, and this fact explains method's efficiency in comparison with other methods. Results - decrease of quantity of postresection complications of patients, operated using plastic methods in comparison with control group patients under distant functional results studying is certainly determined; practical recommendations for application and usage of new distal part stomach cancer surgical treatment, indications for resection depending on spreading and tumor growth form are worked out. Usage of worked out methods of gastrojejunoplasty during stomach part distal resection is the surgical prophylaxis of postgastroresectional complications and provides stable functional effect during further life. This method is introduced into medical process of: Donetsk Regional Oncological Centre, abdominal surgery department of Donetsk Regional Clinical Territory Medical Association, surgery department of Institute of urgent and restorative surgery, city hospital № 16 Donetsk, Odessa Regional Oncological Dispensary, Gorlovka Oncological Dispensary; educational process of Donetsk State Medical University. Area - medicine (oncology).