Oleksenko V. Optimization of surgical treatment of patients with gastric cancer

The thesis is a clinical study aimed at optimizing pathogenetic surgical treatment of gastric cancer patients. As a result of the study, developed and implemented the optimal surgical approach in cancer of the proximal stomach, proposed the best options for reconstruction of the digestive tract and the formation of esophageal-intestinal anastomosis indications to perform resection multivistseralnyh established prognostically unfavorable factors of development and progress of gastric cancer and suggests the optimal amount limfodissektsii performance, peculiarity pathogenesis posthastrektomichnyh major complications. Based on the pathogenesis of disorders of microcirculation in the pancreas during surgery for cancer of the stomach, the proposed measures to prevent the development of complications of acute stress, which allowed to reduce the development of postoperative pancreatic necrosis and mortality of this complication, especially when performing multivistseralnyh operations associated with resection of the pancreas. Based on the pathogenesis of major complications posthastrektomichnyh developed a radically new execution method reconstructive-restorative stage gastrectomy, which allowed to reduce the incidence of alimentary-enterohennuyu vegetative syndrome of 19,6±5,6% to 10,5±7,0%, reflux esophagitis from 12,2±3,8% to 5,3±5,1%, reduce the number of people with a body mass deficit of 17,6±5,3% to 10,5±4,9%, improve quality of life from 84,3±3,4 to 92,5±2,6 points (p<0.05) increased 5-year survival rate of 31,9±3,9% to 38,0±7,1% (p=0,02).