SURGICAL STRATEGY OF TREATMENT OF PATIENTS WITH COMPLICATED LOCALLY ADVANCED STOMACH CANCER

Summary. Objective. Improvement of results of treatment of patients with complicated stomach cancer. Materials and methods. The analysis of the results of operative treatment of 418 patients with complicated locally expanded gastric cancer. The disease was complicated by bleeding in 252 (60.3%) patients, stenosis – in 89 (21.3%), perforation – in 15 (3.5%), their combination – in 62 (14.8%). Results. The common surgical tactics and operations were used at the group of control. The two-staged active-idividualized surgical tactic, that consist of closure by interrupted sutures at first stage and reconstructive operation at second, was used at the basic group. Radical surgery was performed in 168 (40.2%), in 250 (59.8%) – palliative and symptomatic. Postoperative complications arose to 82 patients (19.6%) and postoperative mortality to 7.2% (30 patients). Conclusion. There is the rational of using the two-staged surgical tactic. The implementation of the proposed surgical tactics and new operative interventions contributed to an increase in the number of radical operations from 62 (14.8%) in the comparison group to 106 (25.3%) in the main group and a decrease in postoperative mortality from 8.0% to 6.3%, respectively.