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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nmp</journal-id><journal-title-group><journal-title xml:lang="ru">Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь»</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Sklifosovsky Journal "Emergency Medical Care"</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-9022</issn><issn pub-type="epub">2541-8017</issn><publisher><publisher-name>“N.V. Sklifosovsky Research Institute for Emergency Medicine”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.23934/2223-9022-2024-13-3-346-352</article-id><article-id custom-type="elpub" pub-id-type="custom">nmp-1919</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Лапароскопическиий доступ при радикальном хирургическом лечении осложненного рака желудка: опыт одного центра</article-title><trans-title-group xml:lang="en"><trans-title>Laparoscopic Access in Radical Surgical Treatment of Complicated Gastric Cancer: a Single-Center Experience</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9173-6296</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарасов</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarasov</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тарасов Сергей Андреевич, врач-хирург, младший научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»</p><p>129090, Москва, Большая Сухаревская пл., д. 3</p></bio><bio xml:lang="en"><p>Sergey A. Tarasov, Surgeon, Junior Researcher, Department of Emergency Surgery, Endoscopy and Intensive Care</p><p>Bolshaya Sukharevskaya Sq.3, Moscow, 129090</p></bio><email xlink:type="simple">sat_tarassov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1270-5414</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ярцев</surname><given-names>П. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yartsev</surname><given-names>P. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ярцев Петр Андреевич, доктор медицинских наук, профессор, заведующий научным отделением неотложной хирургии, эндоскопии и интенсивной терапии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»</p><p>129090, Москва, Большая Сухаревская пл., д. 3</p></bio><bio xml:lang="en"><p>Petr A. Yartsev, Doctor of Medical Sciences, Full Professor, Head, Department of Emergency Surgery, Endoscopy and Intensive Care</p><p>Bolshaya Sukharevskaya Sq.3, Moscow, 129090</p></bio><email xlink:type="simple">yartsevpa@sklif.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6802-7336</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кирсанов</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirsanov</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кирсанов Илья Игоревич, кандидат медицинских наук, старший научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»</p><p>129090, Москва, Большая Сухаревская пл., д. 3</p></bio><bio xml:lang="en"><p>Ilya I. Kirsanov, Candidate of Medical Sciences, Senior Researcher, Department of Emergency Surgery, Endoscopy and Intensive Care</p><p>Bolshaya Sukharevskaya Sq.3, Moscow, 129090</p></bio><email xlink:type="simple">borshoff@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1327-6973</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рогаль</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Rogal</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рогаль Михаил Михайлович, кандидат медицинских наук, научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»</p><p>129090, Москва, Большая Сухаревская пл., д. 3</p></bio><bio xml:lang="en"><p>Mikhail M. Rogal, Candidate of Medical Sciences, Researcher, Department of Emergency Surgery, Endoscopy and Intensive Care</p><p>Bolshaya Sukharevskaya Sq.3, Moscow, 129090</p></bio><email xlink:type="simple">rogal.md@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аксенова</surname><given-names>С. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Aksenova</surname><given-names>S. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аксенова Софья Олеговна, клинический ординатор отделения неотложной хирургии, эндоскопии и интенсивной терапии ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ»</p><p>129090, Москва, Большая Сухаревская пл., д. 3</p></bio><bio xml:lang="en"><p>Sofia O. Aksenova, Clinical Resident, Department of Emergency Surgery, Endoscopy and Intensive Care</p><p>Bolshaya Sukharevskaya Sq.3, Moscow, 129090</p></bio><email xlink:type="simple">aksenova_sonya2013@ya.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»<country>Россия</country></aff><aff xml:lang="en">N.V. Sklifosovsky Research Institute for Emergency Medicine<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>11</day><month>10</month><year>2024</year></pub-date><volume>13</volume><issue>3</issue><fpage>346</fpage><lpage>352</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тарасов С.А., Ярцев П.А., Кирсанов И.И., Рогаль М.М., Аксенова С.О., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Тарасов С.А., Ярцев П.А., Кирсанов И.И., Рогаль М.М., Аксенова С.О.</copyright-holder><copyright-holder xml:lang="en">Tarasov S.A., Yartsev P.A., Kirsanov I.I., Rogal M.M., Aksenova S.O.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.jnmp.ru/jour/article/view/1919">https://www.jnmp.ru/jour/article/view/1919</self-uri><abstract><p>В течение последних десятилетий отмечено активное внедрение мини-инвазивных хирургических технологий в лечении различных заболеваний, в том числе рака желудка. В странах Азии и в Европе лапароскопическая гастрэктомия является альтернативой открытой гастрэктомии при раннем раке желудка, с тенденцией к вытеснению последней. В РФ лапароскопическая гастрэктомия осуществляется в единичных специализированных центрах. С 2013 по 2022 год в нашем центре было проведено хирургическое лечение 141 пациента с диагностированным раком желудка на разных стадиях (мужчин — 64, женщин — 39, средний возраст — 60,5±10 лет). Из них 52 пациентам (50,5%) были выполнены открытые оперативные вмешательства (группа I), 51 (49,5%) — лапароскопические операции (группа II). В исследование входили пациенты с диагнозом «рак желудка», осложненным кровотечением или стенозом выходного отдела желудка/кардиэзофагеального перехода, старше 18 лет, подписавшие согласие на обработку персональных данных и включение их клинических данных в исследование, которым было проведено хирургическое лечение. Нами было проанализировано сравнение таких параметров, как длительность оперативного вмешательства и продолжительность госпитализации, показатели госпитальной/безрецидивной 2-летней выживаемости, неосложненного течения послеоперационного периода. Лапароскопически-ассистированные операции длились дольше, однако, ввиду более прецизионной техники и лучшей визуализации анатомических структур, отмечался меньший объем интраоперационной кровопотери. В ходе лапароскопически-ассистированной радикальной резекции желудка удается выполнить более прецизионную лимфодиссекцию, увеличить количество лимфатических узлов в препарате и, таким образом, повысить вероятность обнаружения лимфатических узлов с метастазами, что, в свою очередь, имеет непосредственное влияние на увеличение 2-летней безрецидивной и 2-летней общей выживаемости пациентов. Значимой разницы среди частоты и тяжести послеоперационных осложнений, летальности выявлено не было. Данные сведения являются важным показателем эффективности мини-инвазивного хирургического метода лечения, что указывает на большую безопасность лапароскопического метода по сравнению с вмешательством из лапаротомного доступа.</p></abstract><trans-abstract xml:lang="en"><p>Over the past decades, there has been an active introduction of minimally invasive surgical technologies in the treatment of various diseases, including gastric cancer. In Asian countries and Europe, laparoscopic gastrectomy is an alternative to open gastrectomy for early gastric cancer, with a tendency to displace the latter. In the Russian Federation, laparoscopic gastrectomy is performed in a few specialized centers. From 2013 to 2022, the surgeons of our Center treated 141 patients diagnosed with gastric cancer at different stages (64 men, 39 women, mean age of 60.5±10 years). Of these, 52 patients (50.5%) underwent open surgeries (group I), 51 (49.5%) — laparoscopic surgeries (group II). The study included patients diagnosed with gastric cancer complicated by bleeding or gastric outlet/cardioesophageal junction obstruction, over 18 years of age, who signed consent for the processing of personal data and inclusion of their clinical data in the research and underwent surgical treatment. We analyzed such parameters as the duration of surgical intervention and the duration of hospital stay, the rates of hospital/relapse-free 2-year survival, and uncomplicated postoperative period. Laparoscopic-assisted surgeries lasted longer; however, due to more precise technique and better visualization of anatomical structures, there was a smaller volume of intraoperative blood loss. During laparoscopic-assisted radical gastrectomy, it is possible to perform more precise lymph node dissection, increase the number of harvested lymph nodes and, thus, increase the probability of detecting lymph nodes with metastases; which, in turn, has a direct impact on increasing the 2-year relapse-free and 2-year overall survival of patients. There was no significant difference in the incidence or severity of postoperative complications and mortality. These data are an important indicator of the effectiveness of the minimally invasive surgical method of treatment, which indicates greater safety of the laparoscopic method compared to intervention from laparotomy access.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>рак желудка</kwd><kwd>мини-инвазивные технологии</kwd><kwd>хирургические осложнения</kwd><kwd>2-летняя выживаемость</kwd></kwd-group><kwd-group xml:lang="en"><kwd>gastric cancer</kwd><kwd>minimally invasive technologies</kwd><kwd>surgical complications</kwd><kwd>2-year survival</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. (eds). Cancer Today (powered by GLOBOCAN 2018). IARC CancerBase. 2018, N. 15. 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