[A multidisciplinary approach in the treatment of elderly and senile patients with complications of colon cancer.]

The article presents the results of treatment of elderly and senile patients with complications of colon cancer, in whose perioperative management a multidisciplinary approach was used. The peculiarity of patients in older age groups, caused by polymorbidity, the phenomenon of mutual complication, requires the use of a non-standard approach in the treatment of complicated colon cancer, since the latter is accompanied by negative results. A comparative analysis of the results of treatment of 289 elderly and senile patients with complicated colon cancer by the traditional method and using a multidisciplinary approach was carried out. The patients were divided into two groups: study and control. In addition to the introduction of the principles of a multidisciplinary approach, additional diagnostic methods were used in the main group in order to more specifically determine the type, severity of complications, staging of the window process and determine functional operability. Patients of the main group, taking into account the implementation of a multidisciplinary approach, were operated using endovideosurgical technologies. In the group of patients where a multidisciplinary approach was used using additional diagnostic methods and minimally invasive treatment methods, a more favorable course of the postoperative period was noted with a decrease in postoperative complications (from 44,9 to 27,8%) and mortality (from 8,9 to 5,3%).

[Improvement of diagnostics and tactics of treatment of patients of elderly and senile age with acute obturational pulpositional obstacle of tumor genesis.]

The results of providing care to 346 elderly and senile patients with acute obstructive intestinal obstruction of tumor Genesis were analyzed. In the diagnosis of acute intestinal obstruction, along with traditional diagnostic methods, the dynamics of intra-abdominal pressure and hemodynamic parameters in the visceral arteries of the abdominal aorta were evaluated. Based on the study, it was shown that acute obstructive intestinal obstruction is accompanied by an increase in intra-abdominal pressure and a reduction in blood flow in the visceral arteries of the abdominal aorta. Moreover, the greater the degree of intestinal obstruction, the more pronounced these changes are. The use of these studies made it possible to improve the diagnosis of acute intestinal obstruction of tumor Genesis. In addition, the assessment of these indicators in the dynamics indicated the effectiveness of conservative measures and gave reason to establish more timely indications for performing surgery. A comprehensive approach to timely diagnosis of acute intestinal obstruction of tumor origin allowed us to identify a group of patients who can perform surgical interventions using endovideosurgical technologies. The use of minimally invasive technologies in the treatment of colon cancer complicated by acute intestinal obstruction has reduced the number of postoperative complications and the level of postoperative mortality.

[Immediate results of surgical treatment of complicated colorectal cancer in elderly and senile patients.]

The work analyzes the results of surgical treatment of 545 elderly and senile patients with complicated forms of colon cancer. Among colon cancer complications frequently encountered acute intestinal obstruction (AIO) - 413 (75,8%), less likely to have been identified - perifocal inflammation (PPV) with abscess - 80 (14,7%), bleeding - 30 (5,5 %) and tumor perforation - 22 (4%). Operations on the colon were performed as a traditional method - 408 (74,9%) and with the use of endovideosurgical technologies - 137 (25,1%). 335 (61,5%) of radical, 50 (9,2%) palliative, 160 (29,3%) symptomatic operations were performed. Operations on the colon, performed for the development of cancer complications, were accompanied by a high mortality rate (22,9%) and a high incidence of postoperative complications (37,1%). The most frequent wound complications were 105 (19,3%) and pneumonia 67 (12,3%). The highest postoperative mortality was observed after operations for tumor perforation of colon cancer (59,1%). Endomedosurgical operations on the large intestine were accompanied by fewer postoperative complications (17,5%) and postoperative lethality (2,2%).