Belozorov І. Surgical tactics in patients with acute complicated cancer of large bowel (clіnіcal-experimental study).

Dissertation is devoted to surgical treatment of patients with acute complicated cancer of large bowel. Principles of іndivіdualized choice of mіnіmally invasive interventions taking into consideration type of complication and severity of condition of patient are the basis of the study. The possibility of decompression and stenting of large bowel in acute intestinal obstruction and chemoembolization of arteries of large bowel depending on location of tumor in acute intestinal bleeding is proven in experiment. All proposed methods were used in clinical practice. The results of treatment of 445 patients with complicated colorectal cancer during 1998 - 2009 are summarized in clinical part of study. All patients were divided into control group were standard techniques were used and study group with the same parameters were proposed methods were used. Application of proposed approach in surgical treatment of study group allowed to improve quality of urgent specialized medical aid in patients with acute complicated cancer of large bowel as compared with control group: to increase the number of radical operations on 17.3%, from 94 (46.3%) in control group to 154 (63.6%) in study group, and to decrease the number of patients with colostomies. Postoperative morbidity decreased on 22,7%: from 38.4% in control group to 15.7% in study group, and postoperative mortality decreased on 7,2%, from 15.8% in control group to 8.6% in study group.