Ways of increasing the effectiveness of colon cancer treatment background by diverticulosis
Summary. Objective: to develop an optimal surgical treatment of colon cancer complicated with diverticulosis by the introduction of effective methods of prophylaxis and treatment of suppurative-inflammatory complications, formation of secures colonic anastomosis to increase the proportion of primary reconstructive operations. Materials and methods. From 1992 to 2007 In DACC 89 patients recived surgical procedures for colon cancer associated with diverticulosis (diverticulitis). Medical complication were recorded in 82 (92.1%) cases, including perifocal inflammation — 39 (43,8%). Endolymphatic administration way for antibacterial therapy in perifocal inflammation treatment was used preoperative period in 60 (67.4%) cases, in the postoperative period — 12 (13,5%), in most of cases like continuation of preoperative antibiotic therapy. Developed method of anastomosis is a modification of duplicative anastomosis. Feature of the method was the staining of diverticules before surgical procedure with a solution of methylene blue, which allows us to refine intraoperative the localization and dissemination of diverticules, which, in turn, provided an opportunity to suture between intact diverticules (Patent UA 28166U). Results. The share of primary reconstructive interventions was 86 (96,6%). Intraoperative complications occurred in 7 (7.8%) cases and were not severe. Postoperative complications were noted in 15 (16.8%) cases, anastomotic leakage in only 1 (1.1%) case. Postoperative mortality was 3 (3.3%). Conclusion. Obtained satisfactory results of treatment using the developed treatment tactics and method of forming duplicative colonic anastomosis in patients with colon cancer complicated with diverticulosis showed undoubted practical value of developed method.
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