USING OF ENDOSCOPIC METHODS IN THE TREATMENT OF PATIENTS WITH COMPLICATED FORMS OF COLON CANCER

Background. The question of the possibility of using endoscopic tunneling and tumor stenting in patients with complicated forms of colon cancer as a preoperative method of treating complications and a stage of preparation of the patient for radical surgery remains controversial. Aim: to analyze the results of the use of endoscopic methods in the treatment and diagnostic complex of patients with complicated forms of malignant diseases of the large intestine. Materials and methods. The study group included 109 (100 %) patients with complicated forms of colon cancer: women - 57 (52.29 %), men - (47.71 %), the average age of patients was 69.78 ± 16.37 years. Among the complications of malignant pathology of the colon, 74 (67.89 %) patients were diagnosed with a colon tumor with acute intestinal obstruction, 21 (19.27 %) - with tumor perforation, 6 (5.50 %) patients had acute intestinal bleeding, 3 (2.75 %) - a combination of acute intestinal obstruction with tumor perforation and 5 (4.59 %) - with intestinal bleeding. Colonoscopy was performed using endoscopic devices OLYMPUS EVIS EXERA III (190) (USA) and HUGER GVE-2600 (China). Results. Colonoscopy was performed in 83 (76.15 %) patients underwent colonoscopy. In 7 (8.43 %) patients with acute gastric bleeding, stable hemostasis was achieved, and in 2 (2.41 %) patients, minor capillary leakage of blood from the tumor after coagulation was noted. In 31 (37.35 %) cancer patients with colon obstruction were successfully treated with tumor tunneling, in 7 (8.43 %) patients had a self-expanding metal stent implanted. In another 9 (10.84 %) patients had minimal results after dilatation and tumor tunneling. In 15 (18.07 %) patients, it was not possible to restore passage through the large intestine. In 12 (14.46 %) patients, therapeutic and diagnostic colonoscopy resulted in the development of a complication - perforation of the large intestine in the area of the tumor process. Conclusion. The use of colonoscopy as a primary therapeutic and diagnostic complex is a promising method of eliminating complications (acute colon obstruction and acute colon bleeding) in malignant neoplasms of the colon. The use of endoscopic examination of the large intestine made it possible to completely or partially eliminate acute colon obstruction and acute colon bleeding in 67.47 % of patients, which made it possible to prepare these patients for a radical one-stage oncological surgery. Tunneling and stenting of the colon tumor is an effective and safe method of eliminating acute intestinal obstruction, the complication rate of which was 14.46 %, which is fully consistent with the world literature.