Peculiarities of postoperative complications course and analysis in patients with colon cancer

Abstract

The aim of the work: to improve the results of surgical treatment of patients with colon cancer by minimizing of postoperative complications period.

Materials and Methods. There were evaluated the results of treatment of 609 patients who had undergone radical surgery on the colon due to the tumor process existing in the clinic of the National Cancer Institute. Postoperative complications occurred in 92 (15.4 %) patients. 37 (6.1 %) patients died.

 Results and Discussion. Complications are equally common occurred in both men and women, but much more often in elderly and senile age patients (70.9 %) and with localization of the tumor in the left half of the colon (67.1 %). Only one third of patients had one complication, others had two or more complications. Purulent-inflammatory complications occurred in 64 (10.1 %) patients, they dominated in the structure of postoperative complications (69.7 %). The most dangerous of these was peritonitis, which occurred in 15 patients, 9 of them died. The most serious complications include differences in anastomotic sutures, cardiovascular insufficiency, gastrointestinal intestinal bleeding, pulmonary embolism, obstruction. Significantly some of them were the cause of death after successful completion radical surgery. For prevention and treatment complications at all stages of inpatient treatment we successfully used a set of measures which provided careful preoperative preparation with the maximum possible correction of different functional systems violations, careful preparation of the colon before surgery with laxatives and enemas, severe compliance with the asepsis and antiseptics rules at all stages of the operation, careful technique of surgical intervention in compliance with the principles of case, active postoperative wound management, the use of broad-spectrum antibiotics with preliminary determination of microflora sensitivity, the use of various methods of isolation of the abdo­minal organs cavities for the prevention of purulent complications. Hemostasis was carefully performed during all stages of the operation. The mobilized preparation was removed by using stapling devices. Stitching machines were also used in the imposition of anastomoses between the distal and proximal colon stumps. Peritoneal integrity was carefully restored. After the operation, a sufficient outflow of wound fluid from abdominal cavity was provided. The wound was irrigated with solutions antiseptics. Patients were provided with full parenteral food. Purulent-inflammatory complications most often occurred in patients after Hartmann’s operation. It was performed, as a rule, to elderly and senile age patients or as the first stage of treatment of distal sigmoid colon cancer at intestinal obstruction.