Barannikov K. The Endoscopy and the Minimally Invasive Surgery in the Diagnosis and Treatment of Gastric Cancer Early Stages

The thesis is devoted to the development of endoscopic and morphological methods of early gastric cancer diagnosis and to increasing the efficiency of patients’ treatment with the use of technologies of minimally invasive interventions. The results of the research showed that the individualization of the treatment for the patients with the early gastric cancer is based on the determination of the macro - and microscopic characteristics semiotics of pre - tumor changes and the intraepithelial neoplasm’s malignancy. It is proved that the endoscopic sonographic research of the MLS ultrastructure is a highly informative method for the differential diagnostics of the disease with the GC. The efficiency of the developed algorithm for the mathematical analysis of focal lesions images of the mucous membrane and the EGC in real time is proved. The advanced surgical treatment tactics with the use of dissection techniques in the submucosal layer of the early gastric cancer was applied. The applicable methods for the treatment and the treatment algorithm of the patients with the early stomach cancer contribute to the improvement of direct and long - term results of the patients’ treatment. The methods of the gastric cancer endosurgical treatment in the early stages and methods of the delivery of modern high - tech preparations to the center of lesions with the endoscopic method are developed and implemented in the clinical practice. The methods of endosurgical treatment of gastric cancer in the early stages and methods of delivery of modern high-tech preparations to the center of lesions by the endoscopic method are developed and implemented in clinical practice. The developed algorithm of patients’ treatment with the early gastric cancer promotes the improvement of direct and long - term results of patients’ treatment. It is proved that the use of endoscopic methods of treatment of early gastric cancer is limited by the risk of the lymphogenous metastasis; in these cases it is necessary to perform the laparotomy resection with the lymph node dissection. As a result of the comparison of the Endoscopic Dissection of Submucosal Stomach (EDSS) with standard surgical operations in the treatment of the early gastric cancer it was determined that EDSS for the radicalism and long-term results is not inferior to the standard surgery and thus it is a minimally invasive method of the organ - protective radical treatment with the high quality of life in the postoperative period (p <0.0001).