INFLUENCE OF THE STRATEGY OF A COMPREHENSIVE INDIVIDUALIZED APPROACH TO TREATMENT ON PERIOPERATIVE CHANGES IN THE HEALTH STATUS OF PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION OF TUMOR GENESIS
DOI:
https://doi.org/10.11603/2414-4533.2025.1.15171Keywords:
cancer, colon, complications, intestinal obstruction, prognostic scales, CR-POSSUMAbstract
The aim of the work: to analyze the perioperative changes in the health status of patients with acute intestinal obstruction of tumor genesis, in whom a strategy of a comprehensive individualized approach to the choice of treatment tactics was used, using the prognostic scale CR-POSSUM.
Materials and Methods. The data of 74 (100 %) patients who were treated for malignant pathology of the large intestine complicated by obstruction were analyzed. In the treatment of these patients, the developed strategy of a comprehensive individualized approach to the choice of treatment tactics was used. At the stage of hospitalization, preoperative stage, on the first day of the postoperative period and before discharge from the hospital, patients were assessed by the CR-POSSUM scale.
Results. According to the results of the health assessment at the stage of hospitalization, the average score for physiological subscale (PS) of the CR-POSSUM scale was (11.83±3.67) points, for surgical subscale (SS) – (10.79±2.84) points. The mortality risk was (7.30±2.19) %. In 12–24 hours after a complex of conservative treatment and endoscopic decompression, the score for PS was (10.21±3.02) points (p=0.0012), for SS – (10.51±2.71) points. The risk of mortality was (6.12±1.88) % (p=0.0008). Twenty-four hours after surgery, the average score for PS was (11.62±3.41) points (p=0.0047), while for SS – (10.57±2.73) points (p=0.8671). The risk of mortality was (6.92±1.94) % (р=0.0322).
Conclusions. In patients with acute intestinal obstruction of tumor genesis, using a strategy of an integrated individualized approach to the choice of treatment tactics, it was possible to improve the general health of patients in the preoperative period – the score on the PS of the CR-POSSUM scale decreased from (11.83±3.67) points to (10.21±3.02) points, p=0.0012. Due to the use of the developed tactics, it was possible to reduce the risk of mortality in the study group from (7.30±2.19) % to (6.12±1.88) %, p=0.0008.
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