Kubrak M. A., Zavgorodnii S. M., Danilyk M. B., Rylov A. I.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. Malignant neoplasms of the large intestine occupy a leading place in the structure of oncology in the population of Ukraine and the world as a whole. The incidence rate of colorectal cancer in the world ranges from 4.9 to 32.1, and the mortality rate – from 3.6 to 15.2 per 100,000 population. The aim of the study. To conduct an analysis of the volume and results of the preoperative examination of patients with complicated forms of malignant diseases of the large intestine in the conditions of general surgical hospitals. Object and research methods. The study group included 71 (100%) patients with complicated forms of colon cancer – 35 (49.29%) women and 36 (50.71%) men, whose average age was 67.97±12.71 years. The results are investigated and discussed. The average duration of the disease from the appearance of clinical symptoms of the complication to the moment of hospitalization was 96.00 (48.00; 168.00) hours. Only 8 (11.27%) patients sought help from a family doctor, the remaining 63 (88.73%) engaged in self-medication. According to the examination results, intestinal obstruction was found in 49 (69.01%) patients, perforation of a cavity organ in 13 (18.31%), acute intestinal bleeding was found in 3 (4.23%) patients. In 4 (5.63%) of hospitalized patients there was a combination of acute intestinal obstruction with perforation, in another 2 (2.82%) – intestinal obstruction with bleeding. According to diagnostic data, the presence of a malignant process of the large intestine was detected in 47 (66.20%) patients, 24 (33.80%) patients were diagnosed with a neoprocess only after intraoperative revision of the abdominal cavity. Conclusions. 1. The average duration of the disease from the appearance of clinical symptoms of complications to the moment of hospitalization was 96.00 (48.00; 168.00) hours, while 39 (54.93%) patients noted the appearance of symptoms characteristic of colon cancer in one month and more until the moment of application to a medical institution. 2. Only 8 (11.27%) patients sought help from a family doctor in connection with existing symptoms of malignant colon pathology, the remaining 63 (88.73%) engaged in self-treatment, which indicates the problems of informing patients and organizing primary care sick 3. The examination of patients with complicated forms of colorectal cancer in the conditions of general clinical inpatients is aimed to a greater extent at diagnosing the type of complication, and not its cause, as evidenced by the predominance of general surgical methods of diagnosis (examination radiography of the abdominal organs and ultrasound examination were performed, respectively 64 (90.14%) and 58 (81.69%) patients) over specific methods (irrigoscopy was performed in 17 (23.94%) patients, colonoscopy – 11 (15.49%), CT examination – 21 (29.58%) hospitalized). 4. The insufficient volume of specific diagnostics, due to the existing complication and the need for urgent surgical intervention, leads to the fact that in 24 (33.80%) the diagnosis of malignant formation of the large intestine was made only after intraoperative revision of the abdominal cavity.

colorectal cancer,diagnosis,complications,urgent oncosurgery

1. Kеrnychnyi VV, Sukhodolia AI, Monastyrskyi VM, Moroz VA, Balytskyi VV, Pidmurniak OO. Rezultaty khirurhichnoho likuvannia mistsevorozpovsiudzhenoho raku obodovoi kyshky z poshyrenniam na pidshlunkovu zalozu. Klinicheskaia khirurgiia. 2018;85(8):65-7. DOI: 10.26779/2522-1396.2018.08.65. [in Ukrainian].
2. Rusyn VI, Chobey SM, Dutko OO. Hemikolektomiia pry obstruktyvnomu raku pravoi polovyny obodovoi kyshky. Art of Medicine. 2020 Oct;3(15):144-18. DOI: 10.21802/artm.2020.3.15.144. [in Ukrainian].
3. Fedoronko ZP. Rak v Ukraini 20182019. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby. Bulletin of the National Cancer Registry [Internet]. 2020 [cited 2022 Hryd 11];21:145. Dostupno: http://www.ncru.inf.ua/publications/BULL_21/index.htm. [in Ukrainian].
4. Yevtushenko OI, Kolesnyk OO, Sorokin BV, Burlaka AA, Smachylo II, Smachylo IV. Osoblyvosti perebihu ta analiz pisliaoperatsiinykh uskladnen u khvorykh na rak obodovoi kyshky. Hospital Surgery. 2021 Oct;3:101-5. DOI: 10.11603/2414-4533.2021.3.12547. [in Ukrainian].
5. Kostiuchenko VV, Moskalenko YV, Tarasenko SV, Vynnychenko OI, Shevchenko VV, Vynnychenko OI. Analiz zakhvoriuvanosti na kolorektalnyi rak sered zhyteliv sumskoi oblasti. EUMJ. 2020;8(4):407-23. DOI: 10.21272/eumj.2020;8(4):407-423. [in Ukrainian]. 
6. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394-424. DOI: 10.3322/caac.21492.
7. Tataryn BB, Kryzhanivska AYe, Romanchuk VR, Semeniv PM. Vyzhyvanist khvorykh na rak obodovoi kyshky. Clinical Oncology [Internet]. 2018 [cited 2022 Hryd 11];8(1):53-6. Dostupno: . [in Ukrainian]. 
8. Ivanova YuV, Mushenko EV, Korobov AM, Kondratiuk AN. Khirurhichna reabilitatsiia khvorykh na rak obodovoi kyshky, uskladnenyi perforatsiieiu. Clinical anatomy and operative surgery. 2018 Mar;17(1):90-6. DOI: 10.24061/1727-0847.17.1.2018.15. [in Ukrainian].
9. Vytvytskyi IK, Precel OO, Lozynska LY, Holovchanskyi SO. Diahnostyka i taktyka khirurhichnoho likuvannia kolorektalnoho raku, yakyi rozvynuvsia pid chas vahitnosti. Klinicheskaia khirurgiia. 2021 Mar;88(1-2):99-101. DOI: 10.26779/2522-1396.2021.1-2.99. [in Ukrainian].
10. Perehodko DA, Stadnik EA. Fotodynamichna diahnostyka neoplastychnykh protsesiv tovstoi kyshky. Kharkiv Surgical School. 2019 Dec;5- 6:70-3. DOI: 10.37699/2308-7005.5-6.2019.15. [in Ukrainian].
11. Hrytsenko YuM, Bedeniuk AD, Hrytsenko SYu. Symultannyi ta dvokhetapnyi pidkhody v patsiientiv na metastatychnyi kolorektalnyi rak iz synkhronnym urazhenniam pechinky. Hospital Surgery. 2020 Apr;1:119-24. DOI: 10.11603/2414-4533.2020.1.10610. [in Ukrainian].
12. Bartolini I, Ringressi MN, Melli F, Risaliti M, Brugia M, Mini E, et al. Analysis of Prognostic Factors for Resected Synchronous and Metachronous Liver Metastases from Colorectal Cancer. Gastroenterology Research and Practise. 2018;2018:5353727. DOI: 10.1155/2018/5353727.
13. Duzenko OO. Suchasni pidkhody diahnostyky na etapi likuvannia kolorektalnoho raku. Clinical anesthesiology and intensive care. 2022;2:59-64. DOI: 10.31379/2411.2616.18.2.7. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 4 (167), 2022 year, 179-186 pages, index UDK 616.345-006.6-06-07-089.163

10.29254/2077-4214-2022-4-167-179-186