This journal is
indexed in Scopus
Year 2017 Vol. 25 No 5
F.SH. AKHMETZYANOV1,2,3, V.I. EGOROV 1,2
OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS UNDERGOING OBSTRUCTIVE COLONIC RESECTION
FSBEE HE ”Kazan State Medical University” 1,
SAME “Republican Clinical Oncology Center” 2,
Volga region branch of fsbe “N.N.Blokhin Russian Oncology Research Center” Ministry of Health of RF” 3, Kazan,
The Russian Federation
Objectives. The study of the short-term results of reconstructive operations in patients undergoing obstructive colonic resection in a specialized hospital.
Methods. The data of patients (n=128) with functioning intestinal stoma after obstructive colon resections being treated from January 2011 to December 2016 were analyzed. The reconstruction of the colon was failed in 7 patients. There were 57 males (47.1%) and 64 females (52.9%) from total of 121 patients. The average age of patients was 67.8±10.4 years. There were 55 patients (45,5%) older than 70 years.
The main cause for obstructive resections was large intestinal obstruction – in 103 patients (85.1%); the left-sided tumor of the colon was originated predominantly – in 103 patients (85.1%).
Results. Median time of reconstructive and restorative phase was 6 (1-31) months. In 7 out of 121 patients the disease recurrence was diagnosed intraoperatively (2 cases – single parietal peritoneal metastases, 4 cases – an intestine stump recurrence and mesenteric lymph node metastasis). The end-to-end anastomosis were performed in 107 patients (88.4%); in 10 of them (8.3%) anastomosis was performed by stapler technique. The median postoperative hospital stay was 14 (8-16) days and in patients without complications – 10 (8-12) days. Incisional complications developed in 21 cases (17.4%). Postoperative mortality was 2.5%.
Conclusion. The conducted study has confirmed the treatment efficacy of complicated forms of colorectal cancer as well as performing reconstructions of the colon in a specialized hospital. The optimal time of the reconstruction phase after the obstructive colon resection is considered to be 5-6 months.
- Chissov VI, Starinskii VV, Petrova GV. Sostoianie onkologicheskoi pomoshchi naseleniiu Rossii v 2015 godu [Oncological assistance to the population of Russia in 2015]. Moscow, RF; 2016. 236 p.
- Totikov ZV, Totikov VZ, Kalitsova MV, Medoev VV. Novyi sposob dekompressii pri tolstokishechnoi neprokhodimosti opukholevogo geneza [A new way of decompression in colonic obstruction of tumor origin]. Med Vestn Iuga Rossii. 2016;(3):86-91. doi: 10.21886/2219-8075-2016-3-86-91.
- Lin BQ, Wang RL, Li QX, Chen W, Huang ZY. Investigation of treatment methods in obstructive colorectal cancer. J BUON. 2015 May-Jun;20(3):756-61.
- Osian G. Emergency Surgery for Colorectal Cancer Complications: Obstruction, Perforation, Bleeding. Contemporary Issues in Colorectal Surgical Practice. 2012. ð. 75-87.
- Fujita F, Torashima Y, Kuroki T, Eguchi S. Risk factors and predictive factors for anastomotic leakage after resection for colorectal cancer: reappraisal of the literature. Surg Today. 2014 Sep;44(9):1595-602. doi: 10.1007/s00595-013-0685-3.
- Akhmetzianov FSh, Shaikhutdinov NG, Shaimardanov IV. Organizatsiia lecheniia v ekstrennykh i neotlozhnykh sostoianiiakh, palliativnaia terapiia bol’nykh onkologicheskogo profilia [Organization of treatment in emergency and urgent conditions, palliative therapy of cancer patients]. Povolozh Onkol Vestn. 2014;(1):9-14.
- Blinnikov OI, Dronov AF, Smirnov AN. Laparoskopicheskie operatsii pri ostroi spaechnoi kishechnoi neprokhodimosti u detei [Laparoscopic surgery for acute adhesive intestinal obstruction in children]. Laparoskop Khirurgiia.1993;(1):82-88.
- Luntovskii AM, Kecherukov AI, Chinarev IuB, Plotnikov VV, Spirev VV. Vosstanovlenie nepreryvnosti tolstoi kishki posle operatsii tipa Gartmana [Restoration of colon continuity after operations of the Hartmann type]. Med Nauka i Obrazovanie Urala. 2005;(1):73.
- Khalikov MM, Gataullin IG. Analiz neposredstvennykh i otdalennykh rezul’tatov rekonstruktivno-vosstanovitel’nogo etapa posle operatsii tipa Gartmana [Analysis of immediate and long-term results of the reconstructive-restorative stage after operations of the Hartmann type]. Povolzh Onkol Vestn. 2015;(4):43-46.
- Baek SJ, Kim SH, Lee CK, Roh KH, Keum B, Kim CH, et al. Relationship between the severity of diversion colitis and the composition of colonic bacteria: a prospective study. Gut Liver. 2014 Mar; 8(2):170-76. doi: 10.5009/gnl.2014.8.2.170.
- Zarnescu EC, Zarnescu NO, Costea R, Rahau L, Neagu S. Morbidity after reversal of Hartmann operation: retrospective analysis of 56 patients. J Med Life. 2015 Oct-Dec; 8(4):488-91.
- Son DN, Choi DJ, Woo SU, Kim J, Keom BR, Kim CH, et al. Relationship between diversion colitis and quality of life in rectal cancer. World J Gastroenterol. 2013 Jan 28; 19(4):542-49. doi: 10.3748/wjg.v19.i4.542.
- Groshilin VS, Sultanmuradov MI, Moskovchenko AN, Petrenko NA. Sovremennye aspekty profilaktiki oslozhnenii posle obstruktivnykh rezektsii distal’nykh otdelov tolstoi kishki [Modern aspects of preventing complications after obstructive resections of the distal colon]. Fundam Issledovaniia. 2013;(9-1):24-27.
- Malakhov YP, Lysenko MV. Rekonstruktivnye operatsii na levoi polovine obodochnoi kishki posle radikal’nykh vmeshatel’stv po povodu ee ostroi opukholevoi obstruktsii [Reconstructive surgery on the left side of the colon after radical interventions for her acute tumor obstruction]. Voen-Med Zhurn. 2006; 327(8):20-27.
- Tan WS, Lim JF, Tang CL, Eu KW. Reversal of Hartmann’s procedure: experience in an Asian population. Singapore Med J. 2012 Jan;53(1):46-51.
420012, Russian Federation,
Republic of Tatarstan,
Kazan, Butlerova str., 49,
FSBEE HE “Kazan State Medical University”,
Department of Oncology, Radiation
Diagnosis and Radiation Therapy,
tel.: +927 429-96-71,
Akhmetzyanov F.Sh. MD, Professor, Head of Department of Oncology, Radiation Diagnosis and Radiation Therapy, FSBEE HE “Kazan State Medical University”, Head of medical-diagnostic building N2 of the Republican Clinical Oncology Center of the Ministry of Health of the Republic of Tatarstan, an employee of department for the development of current and prospective methods of treatment of neoplastic diseases of Volga Federal Branch of N.N. Blokhin Russian Cancer Research Center of the Ministry of Health of RF.
Egorov V.I. PhD, Assistant of Department of Oncology, Radiation Diagnosis and Radiation Therapy of FSBEE HE “Kazan State Medical University”, oncologist of the Republican Clinical Oncology Center of the Ministry of Health of the Republic of Tatarstan.