Email this article A comparative analysis of the treatment of patients with acute colonic obstruction obstructive tumor genesis
- Authors: Shabunin A.V.1,2, Grekov D.N.1,2, Gugnin A.V.1,2, Korsheva I.Y.1,2
-
Affiliations:
- Russian Medical Academy of Postgraduate Edication
- Municipal Botkin’s Clinical Hospital
- Issue: Vol 25, No 3 (2017)
- Pages: 476-483
- Section: Clinical and experimental oncology
- URL: https://journals.rcsi.science/pavlovj/article/view/7109
- DOI: https://doi.org/10.23888/PAVLOVJ20173476-483
- ID: 7109
Cite item
Full Text
Abstract
In a retrospective study, a comparative analysis of treatment of 509 patients with acute obstructive colonic obstruction, tumor genesis, which are made of different kinds of surgery (n=384) and stenting of the tumor stricture self-expanding metal stents (n=79). For statistical comparison of results concluded that the endoscopic stenting accompanied by fewer complications, a low mortality, reduces hospitalization time as compared to conventional operations. Stenting may be applicable for continuous decompression in patients with malignant strictures as the final treatment, as well as to the time of decompression in potentially resectable patients as the first stage of treatment («bridge to surgery»). In a retrospective study evaluated the results of clinical observation 509 patients from 2010 to October 2016 were carried out surgery for malignant obstruction of the colon. The first group included 79 patients who performed endoscopic stenting. These patients are the main group. A control group, consisting of two sub-groups, made up of 384 patients whom underwent surgery were performed. First subset patients (330 patients) performed a resection of the left colon departments to form a single-barrel colostomy (Hartmann type of operation), right-sided hemicolectomy with the formation ileotransverzoanastomosis; the second subgroup (54 patients) were formed colonies or ileostomy due to hemodynamic instability and/or the presence of unresectable tumors. We describe the results of the comparison of colorectal stenting and colostomy. The conclusion about the prospects of the use of colorectal stenting in patients with acute colonic obstruction obstructive tumor genesis.
Full Text
##article.viewOnOriginalSite##About the authors
A. V. Shabunin
Russian Medical Academy of Postgraduate Edication; Municipal Botkin’s Clinical Hospital
Author for correspondence.
Email: docgugnin@gmail.com
д.м.н., профессор, зав. кафедрой хирургии Российской медицинской академии последипломного образования; главный врач ГКБ имени С.П. Боткина
Russian Federation, 2/1, Barrikadnaya str., Moscow, 125993; 5, 2-nd Botkinsky pr., Moscow, 125284D. N. Grekov
Russian Medical Academy of Postgraduate Edication; Municipal Botkin’s Clinical Hospital
Email: docgugnin@gmail.com
к.м.н., доцент кафедры хирургии РМАПО; заведующий 17 хирургическим отделением ГКБ имени С.П. Боткина
Russian Federation, 2/1, Barrikadnaya str., Moscow, 125993; 5, 2-nd Botkinsky pr., Moscow, 125284A. V. Gugnin
Russian Medical Academy of Postgraduate Edication; Municipal Botkin’s Clinical Hospital
Email: docgugnin@gmail.com
врач-эндоскопист высшей квалификационной категории, д.м.н. профессор кафедры эндоскопии РМАПО; заведующая эндоскопическим отделением ГКБ имени С.П. Боткина
Russian Federation, 2/1, Barrikadnaya str., Moscow, 125993; 5, 2-nd Botkinsky pr., Moscow, 125284I. Yu. Korsheva
Russian Medical Academy of Postgraduate Edication; Municipal Botkin’s Clinical Hospital
Email: docgugnin@gmail.com
аспирант кафедры хирургии Российской медицинской академии последипломного образования, врач-хирург 17 хирургического отделения ГКБ имени С.П. Боткина
Russian Federation, 2/1, Barrikadnaya str., Moscow, 125993; 5, 2-nd Botkinsky pr., Moscow, 125284References
- Davydov MI, Gantsev ShKh. Оnkologiya [Onkology: textbook]. Moscow: GEOTAR-Media; 2010. (in Russian)
- Fedoseev AV, Budarov VN, Murav'yov SY, Tikhonova MA. Taktika pri obturacionnoj kishechnoj neprohodimosti i vozmozhnosti eyo sovershenstvovaniya [Management of obstructive ileus, and the possibility of its improvement]. Nauka moldykh (Eruditio Juvenium) [Science of young (Eruditio Juvenium)]. 2013; 4: 66-70. (in Russian)
- Fedorov NA, Аmaranth DG. Anato-michekie harakteristiki laparotomii pri tonko-kishechnoj neproho-dimosti [Anatomical characteristics laparotomy with intestinal obstruction]. Zhurnal anatomii i gistopatologii [Journal of anatomy and histopathology]. 2015; 3 (4): 123-4. (in Russian)
- Milyukov VE. Izuchenie osnovnyh patogeneticheskih mekhanizmov posle ustra-neniya ostroj tonkokishechnoj neprohodi-mosti [Study of the basic pathogenetic mechanisms after elimination of acute intestinal obstruction]. Rossiyskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald]. 2001; 3-4: 55-9. (in Russian)
- Kim JH, Ku YS, Jeon TJ, Park JY, Chung JW, Kwon KA et al. The efficacy of self-expanding metal stents for malignant colorectal obstruction by noncolonic malignancy with peritoneal carcinomatosis. Dis. Colon. Rectum. 2013; 56 (11): 1228-32.
- Carraro PG, Segala M, Cesana BM et al. Obstructing colonic cancer: failure and survival patterns over a ten-year follow-up after one-stage curative surgery. Dis Colon Rectum. 2001; 44 (2): 243-50.
- Serpell JW, McDermott FT, Katrivessis H et al. Obstructing carcinomas of the colon. Br J Surg. 1989; 76 (9): 965-9.
- Umpleby HC, Williamson RC. Survi-val in acute obstructing colorectal carcinoma. Dis Colon Rectum. 1984; 27 (5): 299-304.
- Osler M, Iversen LH, Borglykke A, Mårtensson S, Daugbjerg S, Harling H et al. Hospital variation in 30-day mortality after colorectal cancer surgery in denmark: the contribution of hospital volume and patient characteristics. Ann. Surg. 2011; 253 (4): 733-8.
- Dohmoto M. New method – endoscopic implantation of rectal stent in palliative treatment of malignant stenosis. Endosc. Dig. 1991; 3: 1507-12.
- Tejero E, Mainar A, Fernandez L, Tobio R, Degregorio MA. New procedure for the treatment of colorectal neoplastic obstructions. Dis. Colon. Rectum. 1994; 37: 1158-9.
- Tanaka T, Furukawa A, Murata K, Sakamoto T. Endoscopic transanal decompression with a drainage tube for acute colonic obstruction: clinical aspects of preoperative treatment. Dis. Colon. Rectum. 2001; 44 (3): 418-22.
- Lebedev SS, Mumladze RB, Chechenin GM, Barinov YuV, Galaeva EV, Ravich LD. Semenycheva NV. Ispol'zovanie kolorektal'nyh stentov v lechenii bol'nyh s ostroj obtu-racionnoj tolstokishechnoj neprohodimost'yu [Use of colorectal stents in patients with acute bowel obstruction]. Annaly hirurgii [Ann. Surg]. 2014; 5: 27-36. (in Russian)
