OPTIMIZATION OF APPROACHES TO PERFORMING MESOCOLONECTOMY WITH LYMPHADENECTOMY FOR TUMOR GENESIS RIGHT-SIDED COLONIC OBSTRUCTION

The combined prospective-retrospective study analyzed the results of the treatment of 157 patients operated on for obstructive intestinal obstruction due to tumours of the right colon. In the control group (81 patients), risk factors for the development of complications and “nonradicality” of surgical interventions, D2 lymphadenectomy, as well as causes that worsen the general prognosis and long-term oncological results were identified. In the main group, 76 patients underwent a developed complex diagnostic and treatment algorithm and a modified technique of laparoscopic mesocolonectomy with D3 lymph node dissection. The average number of affected lymph nodes in patients of the main group with identified metastases was 17,4 ± 4,2 compared to 10,2 ± 4,6 in patients in the control group.In both groups, the greatest number of complications was observed in patients with decompensated intestinal obstruction and multiple organ failure or a clinic of peritonitis. Intraoperative and postoperative complications in patients in the main and control groups were comparable and did not differ statistically (p > 0,05). A smaller number of anastomotic leaks in patients of the main group (n = 3; 3,9 %) compared with patients in the control group (n = 5; 6,2 %) is associated with the use of intraoperative decompression of the colon.The proposed D3 lymph node dissection technique allows increasing the number of removed lymph nodes without impairing the immediate results of patient treatment.

colon, cancer, acute colon obstruction, mesocolonectomy, right-sided hemicolectomy, lymphadenectomy, tumour, complications

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