actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.12737/article_5955e6b4713763.07402778actabiomedica-357Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEНЕПОСРЕДСТВЕННЫЕ РЕЗУЛЬТАТЫ СИМУЛЬТАННЫХ ОПЕРАЦИЙ ПРИ МЕТАСТАЗАХ КОЛОРЕКТАЛЬНОГО РАКАSHORT-TERM RESULTS OF SIMULTANEOUS SURGERIES AT METASTATIC COLORECTAL CANCERЗагайновА. С.ZagaynovA. S.allexw@yandex.ruШелеховА. В.ShelekhovA. V.avshirkru@yandex.ruЗубковР. А.ZubkovR. A.rzub@yandex.ruИркутская государственная медицинская академия последипломного образования - филиал ФГБОУ «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииIrkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education201728022017212832Copyright © Загайнов А.С., Шелехов А.В., Зубков Р.А., 20172017Загайнов А.С., Шелехов А.В., Зубков Р.А.Zagaynov A.S., Shelekhov A.V., Zubkov R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/357

Проведено ретроспективное исследование, в котором приняли участие 126 пациентов, имевших злокачественную опухоль толстой кишки с метастазами в печени. Пациентам основной группы проводилась резекция толстой кишки и резекция печени. Также во время операции выполняли радиочастотную абляцию метастазов и химиоэмболизацию воротной вены. В контрольной группе выполняли операцию на толстой кишке без вмешательства на печени. Группы сравнивали по длительности операции, объёму интраоперационной кровопотери, пребыванию в стационаре после операции, количеству осложнений и летальных случаев.

We compared the main group of patients (64 persons) underwent colon resection and liver resection, radiofrequency ablation of metastases in the liver and portal vein chemoembolization with the control group (62 persons) with the operation on the colon without intervention on the liver. The blood loss during surgery in the main group was 696.1 ± 226.3 ml and in the control group - 473.3 ± 245.9 ml (p = 0.000008). When performing hemihepatectomy blood loss during surgery was 802.9 ± 208.5 ml, and performing other liver resections - 575 ± 182.2 ml (p = 0.00005). Duration of hospital stay after the surgery in the study group was 16.8 ± 5.1 days and in the control group -14.0 ± 4.1 days (p = 0,001). Duration of hospital stay after the surgery was higher in the patients after hemihepatectomy, compared to the patients who received smaller volume liver resection -19.7 ± 3.9 versus 13.4 ± 3.8 days (p = 0,005). Postoperative complications were more frequent in the patients of the main group -18 (28.1 %) vs 10 (16.1 %). However, increasing the proportion of complications in the patients with simultaneous treatment of complications associated with the summation operations on the colon and liver operations. Performing liver resection is an independent factor contributing to the prolongation of operative time and blood loss, which increases the frequency of postoperative complications and increases duration of the patient's stay in the hospital.

метастатический колоректальный ракхимиоэмболизациярезекция печениmetastatic colorectal cancerchemoembolizationhepatic resectionReferencesAdam R., Pascal G., Azoulay D., Tanaka K., Castaing D., Bismuth H. (2003). Liver resection for colorectal métastasés: the third hepatectomy. Ann. Surg., (238), 871-884.Adam R., Pascal G., Azoulay D., Tanaka K., Castaing D., Bismuth H. (2003). Liver resection for colorectal métastasés: the third hepatectomy. Ann. Surg., (238), 871-884.Fernandez F.G., Drebin J.A., Linehan D.C., Dehdashti F., Sigel B.A., Strasberg S.M. (2004). Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose [FDG-PET]. Ann. Surg., (240), 438-447.Fernandez F.G., Drebin J.A., Linehan D.C., Dehdashti F., Sigel B.A., Strasberg S.M. (2004). Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose [FDG-PET]. Ann. Surg., (240), 438-447.Figueras J., Valls C., Rafecas A., Fabregat J., Ramos E., Jaurrieta E. (2001). Resection rate effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br. J. Surg., (88), 980-985.Figueras J., Valls C., Rafecas A., Fabregat J., Ramos E., Jaurrieta E. (2001). Resection rate effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br. J. Surg., (88), 980-985.Nordlinger B., Sorbye H., Glimelius B., Poston G.J., Schlag P.M., Rougier P., Bechstein W.O., Primrose J.N., Walpole E.T., Finch-Jones M., Jaeck D., Mirza D., Parks R.W., Colette L., Praet M., Bethe U., van Cutsem E., Scheithauer W., Gruenberger T. (2008). Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer [EORTC Intergroup trial 40983]: a randomised controlled trial. Lancet, (371), 1007-1016.Nordlinger B., Sorbye H., Glimelius B., Poston G.J., Schlag P.M., Rougier P., Bechstein W.O., Primrose J.N., Walpole E.T., Finch-Jones M., Jaeck D., Mirza D., Parks R.W., Colette L., Praet M., Bethe U., van Cutsem E., Scheithauer W., Gruenberger T. (2008). Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer [EORTC Intergroup trial 40983]: a randomised controlled trial. Lancet, (371), 1007-1016.Parks R.W., Garden O.J. (2001). Liver resection for cancer. World J. Gastroenterol., (7), 766-771.Parks R.W., Garden O.J. (2001). Liver resection for cancer. World J. Gastroenterol., (7), 766-771.Rees M., Plant G., Bygrave S. (1997). Late results justify resection for multiple hepatic metastases from colorectal cancer. Br. J. Surg., (84), 1136-1140.Rees M., Plant G., Bygrave S. (1997). Late results justify resection for multiple hepatic metastases from colorectal cancer. Br. J. Surg., (84), 1136-1140.Scheele J., Stang R., Attendorf-Hofmann A., Martin P. (1995). Resection of colorectal liver metastases. World J. Surg.,(19), 59-71.Scheele J., Stang R., Attendorf-Hofmann A., Martin P. (1995). Resection of colorectal liver metastases. World J. Surg.,(19), 59-71.Wagner J.S., Adson M.A., Van Heerden J.A., Adson M.H., Ilstrup D.M. (1984). The natural history of hepatic metas-tases from colorectal cancer: a comparison with respective treatment. Ann. Surg., (199), 502-508.Wagner J.S., Adson M.A., Van Heerden J.A., Adson M.H., Ilstrup D.M. (1984). The natural history of hepatic metas-tases from colorectal cancer: a comparison with respective treatment. Ann. Surg., (199), 502-508.Wood C.B., Gillis C.R., Blumgart L.H. (1976). A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin. Oncol., (2), 265-268.Wood C.B., Gillis C.R., Blumgart L.H. (1976). A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin. Oncol., (2), 265-268.

The authors declare that there are no conflicts of interest present.