Radical Single-Stage Operations at Intestinal Obstruction, Caused by the Tumor of the Left Half Part of the Large Intestine (Current Status of the Problems)

Abstract

In more than 40% of cases, colon cancer (CС) is diagnosed in stages III-IV, at the same time the resectability reaches 70-80%. The main priority of surgical intervention by obturation of intestinal obstruction at the first stage is the bowel emptying from the contents and the elimination of its obstruction. Intraoperative entero- and colon lavage with subsequent colosorption facilitate single-stage surgical interventions. When treating patients with decompensated intestinal obstruction, preference is given to more sparing and multi-stage surgical interventions. The key point of the operation is the removal of the tumor in full volume R0. Segmental left-sided colectomy can be performed in the presence of adequate edges of R0, as well as the conduct of lymphadenectomy. In the case of the presence of a locally advanced process involving neighboring organs, it is possible to perform a so-called «curative resection», an «an block» resection with complete or partial removal of the involved organs together with the tumor. In patients with compensated and subcompensated intestinal obstruction, it is possible to perform intestinal resection with the formation of a primary anastomosis. In recent years, endosurgical techniques for restoring the passage of intestinal contents, which can be considered as a method of preparing the patient for radical treatment, have become very popular in the treatment of patients with tumour obstruction. The possibility of open treatment of patients suffering from CC largely depends on the presence or absence of metastases in the liver. If their presence, in some cases, it is possible to perform anatomical resections of the affected areas of the liver. Early postoperative results of surgical treatment of patients after removal of large intestine tumours largely depend on the full preparation of the intestine, the presence of concomitant diseases, as well as the ways of protection of the anastomosis and its type. Keywords: Intestinal obstruction, intestinal anastomosis, colon cancer, one-stage operations on the large intestine.