Problems of Surgical Treatment of Gastric Malignant Neoplasms Complications

Abstract

The frequency of complications of malignant neoplasms (MN) of the stomach remains high (10-40 %) and does not show a constant tendency to decrease, despite the introduction of new methodological approaches.The aim of the study. To analyze the factors of successful surgical treatment of gastric lesions, which in turn can be a prerequisite for optimizing surgical tactics in such patients.Material and methods. The research design included a statistical analysis of the medical records of 6,885 oncological patients with abdominal localization of gastric MN and an assessment of the results of treatment of 56 patients with a complicated course of gastric MN. All patients involved in the study signed the appropriate informed consent. The average age of the patients was 56.3±8.61 years, men signifi cantly predominated in the cohort of patients with gastric lesions – 76.79 % against 23.21 % women. Patients were managed according to the ESMO 2022 Gastric cancer Clinical Practice Guideline for diagnosis, treatment and follow-up.Research results. A special feature of gastric MN is its diagnosis in the late stages – the number of patients in the IV stage doubled the number of III stage patients and tripled the number of I-II stages patients. Among the gastric MN complications perforation was observed in 51.79 %, gastrointestinal bleeding in 26.79 %, andgastric stenosis in 21.43 %.Conclusions. The choice of the nature, scope and stages of surgical intervention in patients with gastric MN should take into account the prevalence of the oncological process, the nature and severity of complications, the presence of comorbidities and the characteristics of the patient’s condition. Water-electrolyte and metabolic disorders in complicated gastric MN require a longer period of correction with consideration of options for endoscopic recanalization and enteral therapy, which creates conditions for radical removal of the process during emergency surgical interventions. The contingent of patients with complicated forms of gastric MN requires a complex individual approach and optimized surgical treatment to ensure quality of life in the immediate and long-term postoperative periods.