PROBLEMS OF PREOPERATIVE DIAGNOSTICS OF PATIENTS WITH COMPLICATED FORMS OF COLORECTAL CANCER IN GENERAL SURGICAL HOSPITALS

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

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«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