ORIGINAL INVESTIGATIONS Original article ANALYSIS OF MORBIDITY AND MORTALITY IN PATIENTS WITH ACUTE COLONIC OBSTRUCTION OF TUMOR ORIGIN (ACCORDING TO THE MATERIALS OF THE CLINIC)
The purpose of the study is to analyze the data on the examination and treatment of patients with colon cancer complicated by obstructive intestinal obstruction. Materials and methods. The analysis of morbidity and mortality in 321 patients with acute colonic obstruction of tumour origin was carried out based on the materials of two surgical clinics in Astrakhan. Examination of all patients included rеpeated measurement of intra abdominal pressure. Research results. It was found that out of 321 observed patients, 32 (9,9 %) patients managed to eliminate acute colonic obstruction of tumour genesis conservatively without surgical interventions, and the remaining 289 patients were operated on. Out of 96 patients with decompensated intestinal obstruction, two groups of patients were formed: the main group included 61 patients operated on with stoma removal and the comparison group - 35 patients operated radically with tumour removal by various methods. Thus, in 2016, the removal of the stoma for bowel decompression was performed in only 2 out of 12 patients (16 %), in 2017 - in 5 out of 17 patients (29 %), in 2018, the stoma was removed in 9 out of 16 patients (56 %). There was no mortality in this group of patients, and postoperative mortality in the comparison group was 37,9 %. Taking into account the high mortality in the comparison group since 2019, we have changed tactics and developed an algorithm for providing care to patients with decompensated intestinal obstruction using our developed device for intestinal decompression. Over the period 2019-2021, the number of withdrawn stomas increased by almost 3 times compared to 2016-2018. For three years, out of 51 patients, the stoma was removed in 45 patients (88,2 %). Mortality in this group of patients was 2,2 %, and postoperative mortality in the comparison group was 16.6 %. The average bed day in these patients was 10,4 ± 0,31 and 12,2 ± 0,79, respectively. Conclusion. Based on the results obtained, it was concluded that the introduction of minimally invasive methods of intestinal decompression into the practice of general surgical hospitals in case of decompensated acute colonic obstruction of tumour genesis can reduce the length of stay of patients in the hospital, reduce mortality and the number of postoperative complications.