Keywords
oncology
cancer
colon
intestinal obstruction
How to Cite
Abstract
Backgrounds. Acute Intestinal Obstruction (AIO) is one of the most common complications of colon cancer, the frequency of which ranges from 40.00% to 60.00%.
Aim. To conduct a comparative analysis of perioperative changes in the health status of patients with acute intestinal obstruction of tumor genesis using the prognostic scale CR-POSSUM (ColoRectal Physiologic and Operative Severity Score for the enUmeration of Mortality).
Materials and methods. Data from 123 (100.00%) patients who underwent treatment for AIO of tumor genesis were analyzed. Patients were divided into two groups: a comparison group, in the treatment of which methods were used according to the existing standards for the treatment of AIO (Order of the Ministry of Health of Ukraine No.1422) and the main group, which underwent examination and treatment according to the developed strategy. At the stages of treatment, the patients' health status was assessed using the CR-POSSUM scale. Statistical processing was carried out using the computer programs Statistica 13.0 and Excel 2013 using non-parametric statistical methods. The study was carried out within the framework of the research work of the Department of General Surgery and Postgraduate Surgical Education of the Zaporizhia State Medical and Pharmaceutical University (No.0122U201230).
Research Ethics. All procedures that took place in the studies were carried out with the informed consent of the participants and met the ethical standards of the institutional research committee of the Zaporizhia State Medical and Pharmaceutical University, as well as the Declaration of Helsinki of the World Medical Association (1964–2024).
Results. The use of the developed strategy made it possible to prepare the patient and maximally compensate for changes in his general condition before performing the surgical intervention, as evidenced by a decrease in the score on the physiological subscale of the CR-POSSUM scale after treatment ([10.21±3.02] points) compared to the score at the stage of hospitalization ([11.8±3.67] points, p=0.0012). Preoperative comprehensive preparation of patients with intestinal obstruction for surgical intervention allowed patients to more stably endure the early postoperative period without worsening of the general condition: in the comparison group, perioperative changes in health status were estimated at [10.94±3.12] points before and [12.37±3.79] points after the intervention (p=0.0032), in the main group – [10.21±3.02] points and [10.62±3.11] points, respectively (p=0.6247 and p=0.0295).
Conclusions. The use of the developed treatment strategy for patients with AIO of tumor genesis allows preparing the patient and maximally compensating for changes in his general condition before performing surgical intervention, to more stably endure the early postoperative period without worsening of the general condition and to reduce postoperative mortality risks by almost 2.5 times compared to this indicator in the comparison group.
Keywords: surgery, oncology, cancer, colon, intestinal obstruction.
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