[Minimally invasive interventions in emergency large bowel surgery]. / Miniinvazivnye vmeshatel'stva v urgentnoi khirurgii tolstoi kishki.

The current trends in the treatment of various surgical diseases of large bowel using minimally invasive operations are reviewed in the manuscript. It is shown that laparoscopy is currently possible in most cases for urgent large bowel diseases.

[Early and long-term outcomes of minimally invasive interventions in urgent colon surgery]. / Blizhaishie i otdalennye rezul'taty mini-invazivnykh vmeshatel'stv v urgentnoi khirurgii tolstoi kishki.

OBJECTIVE: To analyze the results of minimally invasive surgical treatment of patients with urgent colon diseases. MATERIAL AND METHODS: There were 89 patients with urgent colon diseases. All patients were divided into 2 groups: the main group - 31 patients who underwent laparoscopic surgeries, the control group - 58 patients operated via open access. Both groups were comparable by age and underlying disease. However, significant differences in gender, severity of comorbidities and complications of the underlying disease were observed. RESULTS: Surgery time, postoperative morbidity (9.7% vs. 6.9%) and postoperative hospital-stay were similar in both groups. Quality of life was significantly better in the main group compared with the control group if colostomy was absent. In case of stoma, there were no between-group differences. CONCLUSION: Laparoscopic surgery is associated with reduced need for analgesics, similar duration of intervention and postoperative morbidity. Complete restoration of quality of life in these patients is observed in 6 months after surgery. Colostomy results similar quality of life after laparoscopic and open surgery.

[Surgical treatment of colon cancer in advanced age patients with severe comorbidities]. / Vliyanie komorbidnogo fona na vozmozhnost' khirurgicheskogo lecheniya bol'nykh rakom obodochnoi kishki pozhilogo i starcheskogo vozrasta.

OBJECTIVE: To analyze surgical (including minimally invasive) treatment of advanced age patients with colon cancer and severe comorbidities. MATERIAL AND METHODS: Advanced age patients with colon cancer (≥60 years) were compared with younger ones. Concomitant diseases were detected in 94,4% of older patients and in 45,9% of patients in the control group (χ2=51,747; p<0,001). RESULTS: Surgery time, intraoperative blood loss, length of hospital-stay, postoperative morbidity and mortality were similar. CONCLUSION: Severe comorbidities did not significantly affect surgical outcomes in these patients and did not increase postoperative morbidity and mortality.

[Minimally invasive surgery for colorectal cancer in advanced age patients]. / Miniinvazivnaia khirurgiia kolorektal'nogo raka u bol'nykh pozhilogo i starcheskogo vozrasta.

AIM: To evaluate the role of laparoscopic surgery for colorectal cancer in advanced age patients. MATERIAL AND METHODS: 290 patients with colorectal cancer were enrolled including 121 patients with rectal cancer and 169 patients with colon cancer. Main group consisted of 171 patients over 60 years old, control group - 119 patients younger 60 years old. RESULTS: Radical advanced procedures on different parts of colon including laparoscopic approach were performed in the majority of advanced age patients. Outcomes were considered as good, we did not notice serious complications (5.4% after rectal surgery, 3.9% after colon surgery). Differences were not significant compared with younger patients including laparoscopic interventions for emergency indications. Nevertheless, surgical treatment of advanced age patients with colorectal cancer makes special demands for equipping of the clinic and physicians' qualification. CONCLUSION: Advanced age is not a serious limitation in choice of laparoscopic access in both elective and emergency surgery in patients with colorectal cancer.

[Efficacy of video-assisted procedures in advanced age patients with colorectal cancer]. / Éffektivnost' videoéndoskopicheskikh vmeshatel'stv u bol'nykh kolorektal'nym rakom starshikh vozrastnykh kategorii.

AIM: To assess advisability of video-assisted surgery in advanced age patients with colorectal cancer. MATERIAL AND METHODS: The study involved 44 patients with large intestine tumors. There were 30 patients with colon cancer aged 78.0±1.1 years and 14 patients with rectal neoplasms aged 75.0±1.8 years. All of them underwent elective video-assisted resections without conversion of the approach. RESULTS: Good and satisfactory results were achieved in 95.5% of patients. Postoperative complications occurred in 5 (11.4%) cases followed by redo surgery in 2 (4.5%) patients. Mortality was absent. CONCLUSION: Video-assisted procedures are preferable in elective surgery of colorectal cancer in advanced age patients regardless stage and localization of the process.

[Emergency endoscopic surgery of colon cancer]. / Vozmozhnosti ékstrennoi videoéndoskopicheskoi khirurgii raka obodochnoi kishki.

AIM: To assess the role of endoscopic technologies in treatment of complicated forms of colorectal cancer. MATERIAL AND METHODS: Our trial included patients after endoscopic intervention (n=18) and open surgery (n=11). RESULTS: Mean time of surgery in this group was 158.8±10.7 minutes. In elective surgery group this value was 161.3 minutes (p>0.05). Mean blood loss was not great (near 122.5±17.9 ml). Overall and postoperative hospital-stay was 23.1±2.4 and 8.6±0.5 days, respectively. There were no intraoperative and postoperative complications. CONCLUSION: Endoscopic interventions may be performed for colon cancer for emergency indications including patients with severe complications.

[Endoscopic interventions in patients with colorectal cancer: the effect of comorbidities]. / Videoéndoskopicheskie vmeshatel'stva u bol'nykh kolorektal'nym rakom.

AIM: To evaluate endoscopic technologies in treatment of patients with colorectal cancer and severe comorbidities. MATERIAL AND METHODS: Two groups of patients after endoscopic (group 1, n = 58) and open (group 2, n = 40) surgery were assessed. RESULTS: Comorbidities were observed in 90.7% patients in group 1 and 83.3% patients in group 2 (p > 0.05). Mean comorbidity index was 6.9±0.3 (2-14) and 7.1±0.7 (2-18) in both groups respectively. Comorbidities ASA grade 3-4 were observed in 88.2% patients of group 1 had and in 71.4% patients of group 2 (p > 0.05). One patient of group 1 with intra-abdominal bleeding required conversion of surgical approach. In another case the conversion was due to technical difficulties during intestinal resection. Postoperative complications were noted in 2 patients (3.4%). There were no intraoperative complications in group 2. Postoperative complications were observed in two cases (5.0%). CONCLUSION: Severe comorbidities do not impose serious restrictions on the choice of endoscopic approach in colorectal cancer patients.

[Laparoscopic surgery for colon cancer]. / Laparoskopicheskaia khirurgiia raka obodochnoi kishki.

AIM: To assess laparoscopic surgery in treatment of colon cancer patients. MATERIAL AND METHODS: The results of laparoscopic treatment of patients with colorectal cancer are presented in the article. It was estimated the influence of various clinical parameters including age, gender, comorbidities, tumor localization and stage and complications on laparoscopic management of these patients. CONCLUSION: It was revealed that efficiency of laparoscopic surgery in patients with colon cancer is affected by tumor stage and presence of complications.