Complex approach in the treatment of postoperative complications of gastrectomy

Abstract

Relevance. At the present stage of development of oncology, the level of locally advanced and metastatic cancer of the stomach is high, in total according to 2017 year stage III and IV were diagnosed with 63.7% of all newly diagnosed cases of gastric cancer. The surgical method is basic in the treatment of stomach cancer. Complications of the surgical treatment of gastric cancer, leading to the impossibility or delay of adjuvant treatment, significantly worsen the rates of relapse-free and overall survival. Due to the large difference in the frequency of complications (from 9% to 32%) with surgical aids, the development of combined methods for their treatment is relevant.

Objective. In this clinical case, demonstrated a stepwise approach in the treatment of postoperative complications of gastrectomy using conservative and active surgical methods, including minimally invasive endoscopic technologies.

Research materials. A case study of the treatment of complications of combined gastrectomy using a variety of approaches is presented. Research methods. Evaluation of treatment tactics for postoperative complications of gastrectomy using conservative, endoscopic and active surgical approaches, in comparison with published data.

Results. Using a wide arsenal of therapeutic measures, it was possible to stop severe complications after gastrectomy. Conclusion. Surgical tactics using minimally invasive technologies in combination with intensive care made it possible to timely eliminate the purulent-septic complications. This clinical case demonstrates the applicability of the simultaneous and sequential use of conservative treatment, active surgical tactics and minimally invasive endoscopic technologies in the treatment of severe complications of gastrectomy. The choice of tactics in each specific case of the development of postoperative complications should be individual, while the use of only conservative treatment is associated with less efficiency and
greater mortality compared to the combined approach.