1.GBU SPb Research Institute of them. I.I. Janelidze
2. Military Medical Academy. CM. Kirov
Brief summary
Stomach cancer for a long time occupies a leading position in the frequency of occurrence among malignant tumors of the gastrointestinal tract. More than half of the patients seek specialized medical care at stage III-IV, and in 30% of these patients the disease is locally common. Necrosis of tumor tissue cells accompanies the tumor from the very beginning of its development, and only after reaching a certain volume becomes clinically important determining the further course of the disease. In the end, the manifestation of clinical manifestations of necrosis leads to severe life-threatening complications that require emergency surgical treatment. Mortality after such operations reaches 60-70%. Based on this, it is necessary to operate on such patients before the development of complications. The article presents the method of preparation and some technical features of surgical interventions in patients with locally advanced gastric tumor on the example of patient K. The preparation is based on a thorough study of these instrumental methods of diagnosis, followed by planning the sequence of stages of the operation. This, in our opinion, will increase the percentage of radical surgical interventions, the safety of surgery, reduce the time of surgery, reduce mortality, the number of complications (primarily intraoperative) and their severity. Technical features are presented by using the technique of visceral rotations in the surgery of locally advanced tumors of the abdominal cavity. Careful preoperative planning of combined surgery, based on a detailed analysis of the results of examination of patients with locally advanced tumors complicated by necrosis, as well as the widespread introduction into surgical practice of the principles of embryologically based surgery can not only reduce the trauma of multivisceral resections, reduce the frequency of postoperative complications and mortality, but also significantly increase their radicalism, creating the necessary conditions for effective adjuvant therapy and, as a consequence, reduce the frequency of postoperative complications and mortality., improvement of long-term results of treatment of this category of patients.
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