THE TACTICS OF SURGICAL TREATMENT FOR GASTRIC BLEEDING TUMORS IN ELDERLY AND SENILE PATIENTS
B. V. Sigua,
V. P. Zemlyanoy,
I. I. Gubkov,
A. M. Danilov,
D. S. Sakhno,
E. A. Zakharov,
A. B. Guslev https://doi.org/10.23934/2223-9022-2018-7-2-152-155
Abstract
The results of treatment of 112 patients of elderly and senile age patients with non-metastatic gastric cancer, complicated by bleeding were analyzed. Most often bleedings occurred for stomach cancer stage III−IV. The tumor was commonly located in the gastric body. The vast majority of patients had only one complication — bleeding. In the second (control) group, there was no unified diagnostic and treatment algorithm, patients were usually operated urgently upon admission or in case of recurrent bleeding. The differential diagnostic and treatment algorithm was developed for patients of group I (main) taking into account the condition of a patient and the severity of bleeding or repeated bleeding. In the control group, the indications for emergency surgery were continued bleeding and inefficiency of endoscopic hemostasis. In the main group, the risk of recurrent bleeding was considered as well, and in case of high risk emergency surgery was performed after a full preoperative preparation. In addition, the cardial part or 2/3 of the stomach were not resected by reason of the deliberate non-radical tactics. It is worth noting that in the I group argon plasma coagulation, complemented by the hemostatic system EndoClot was used for endoscopic hemostasis. Through the use of the developed algorithm we managed to reliably reduce the frequency of complications from 50 to 28.5% (p<0.05), and mortality rate from 28.8 to 3.77% (p<0.001).
About the Authors
B. V. Sigua
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Dr. Med. Sci.,associate professor, Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
V. P. Zemlyanoy
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
I. I. Gubkov
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
A. M. Danilov
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
D. S. Sakhno
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
E. A. Zakharov
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
A. B. Guslev
I.I. Mechnikov North-Western State Medical University
Russian Federation
Russian Federation
Department of Faculty Surgery named after I.I. Grekov,
ulitsa Kirochnaya, 41, Saint-Petersburg 191015
References
1. Davydov M.I., Ter-Ovanesov M.D. Modern strategy of surgical treatment of gastric cancer. Sovremennaya onkologiya. 2000; 2(1): 4–10. (In Russian).
2. Chissov V.I., Starinskiy V.V., Petrova G.V., eds. Malignant tumors in Russia in 2011 (morbidity and mortality). Moscow: FGBU MNIOI im PA Gertsena Publ., 2013. 289 p. (In Russian).
3. Yankin A.V. Screening for gastric cancer. Tuberkulez i bolezni legkikh. 2010; 11(2): 95–100. (In Russian).
4. Parkin D.M. Global cancer statistics in the year 2000. Lancet Oncol. 2001; 2(9): 533–543. PMID:11905707. DOI: 10.1016/S1470-2045(01)00486-7.
5. Suzuki H., Gotoda T., Sasako M., Saito D. Detection of early gastric cancer: misunderstanding the role of mass screening. Gastric Cancer. 2006; 9(4): 315–319. PMID: 17235635. DOI:10.1007/s10120-006-0399-y.
6. Lyutov R.V. Morbidity of stomach cancer and its relapse in patients of different age. Uspekhi gerontologii. 2009; 22(2): 326–329. (In Russian).
7. Chissov V.I., Starinskiy V.V., Petrova G.V., eds. Malignant tumors in Russia in 2005. Moscow: FGBU MNIOI im PA Gertsena Publ., 2007. 252 p. (In Russian).
Review
For citations:
Sigua B.V., Zemlyanoy V.P., Gubkov I.I., Danilov A.M., Sakhno D.S., Zakharov E.A., Guslev A.B. THE TACTICS OF SURGICAL TREATMENT FOR GASTRIC BLEEDING TUMORS IN ELDERLY AND SENILE PATIENTS. Russian Sklifosovsky Journal "Emergency Medical Care". 2018;7(2):152-155. https://doi.org/10.23934/2223-9022-2018-7-2-152-155
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