OBJECTIVE

To study the possibilities of using video laparoscopic technologies in the treatment of colon cancer complicated by acute obstruction.

MATERIAL AND METHODS

The study included the results of treatment of 167 patients with colon cancer complicated by acute obstruction.

RESULTS

Stage I of acute obstruction was detected in 54 (32.3%) patients, stage II in 62 (37.1%) patients, and stage III in 51 (30.6%) patients. Patients with stage I of obstruction were operated for 8—12 days after correction of metabolic and cardiovascular disorders. Endoscopic recanalization of the tumor channel was performed in 9 (14.5%) patients with stage II and 8 (15.7%) patients with stage III. The rest of the patients with II and III stage of the intestinal obstruction in the first stage was performed proximal stoma discharge through a mini access. Right-sided hemicolectomies with laparoscopic access were performed in 11 (6.6%) patients. Typical video laparoscopic approaches and technologies were used in 6 patients. In 5 patients with ileostomy was used in the original technology. An attempt to perform left-sided hemicolectomies with laparoscopic access was initiated in 74 (44.3%) patients. In 5 (3.0%) patients, due to technical difficulties, surgical interventions were continued in an open manner. The remaining 69 (41.3%) patients completed laparoscopic access. After laparoscopic operations, 2 (2.5%) patients died in the postoperative period, and inflammatory complications were detected in 7 (8.8%) patients.

CONCLUSION

Performing a predicted conservative or minimally invasive surgical decompression allows you to resolve the obstruction, correct cardiovascular and metabolic disorders, that is, create conditions similar to the planned ones. Applying stomas via mini-access, including using original methods for planned right-sided hemicolectomies, allows you not to change the typical location of the ports, as well as the technique of performing laparoscopic interventions, except for the original methods.