Staged surgery for complicated cancer
In case of obstruction and perforation, the primary anastomosis is dangerous - a two-stage tactic saves lives and preserves radicality: the tumor is removed with the lymph nodes immediately, the rectal stump is sutured, the colostomy is removed at the marked point. The patient is trained in care before discharge; Chemotherapy according to histology begins after healing. Closure of the stoma (page in the surgery section) is planned after completion of treatment and monitoring. The “no consumables” option allows you to purchase staplers and blood components according to specifications yourself.
Indications
- stomach cancer - gastrectomy/resection with lymph node dissection D2;
- tumors of the colon and rectum with complications - resection with colostomy (Hartmann operation);
- metastases and primary liver tumors - atypical resections;
- adhesive process involving the intestine in tumors - resection with restoration.
Oncological standards
Radicality in abdominal oncology surgery is determined by the margins of resection and lymph node dissection: for gastric cancer - D2 (removal of 1st and 2nd order nodes), for colorectal cancer - resection with mesentery (CME/TME). Complicated tumors (obstruction, perforation) are operated on in stages: first, eliminating the threat with a colostomy, then restoring continuity. Hepatic metastases of colorectal cancer are resected with a good prognosis if completely removed. Each case goes through a consultation; perioperative chemotherapy is planned according to protocols.
