USE OF MODERN TECHNOLOGIES IN THE CHOICE OF TREATMENT AND DIAGNOSTIC TACTICS FOR COLORECTAL CANCER

Summary. Introduction. The problem of tumor lesions of the colon remains one of the main in clinical medicine due to the widespread prevalence and tendency to increase colorectal cancer (CRC), the lack of effective methods for preventing and treating dangerous complications that often develop. Aim. The improvement of the results of surgical treatment of patients with CRC by studying the possibilities of video laparoscopy and choosing the optimal tactics based on assessing the severity of the condition and cytokine status of the patient. Material and methods. The results of treatment of 155 patients with CRC who were treated at the clinic of the State Institution “Zaitsev V.T. IGUS of the National Academy of Medical Sciences of Ukraine”, which is the clinical base of the Department of surgery #1 of KhNMU, were studied. When choosing treatment tactics for patients, the stage of the tumor lesion, the level of acute intestinal obstruction (AIO), the level of endogenous intoxication assessed on the APACHE II and SAPS severity scales, as well as the state of the immune system – on the level of IL-6 in the blood were taken into account. Results. In all cases, the nature and time of preoperative preparation was determined based on the study of clinical and laboratory parameters of the IL-6 level in the blood serum, as well as a point assessment of the severity of the physiological state of patients on the APACHE II and SAPS integral scales. With the correct selection of patients, laparoscopically assisted operations were performed, which give a lower percentage of complications, a more favorable postoperative period, and a shorter hospitalization period than traditional operations. Thus, in emergency patients, intestinal motility appeared on the third day after surgery (3.85±0.11), and gas discharge began 4 days later (4.33±0.04), the appearance of independent emptying was noted on the fifth day after surgery. Conclusions. Integral point assessment of the condition of patients with AIO in CRC using the APACHE II and SAPS systems allows you to choose the optimal amount of surgical intervention: – in 1-2 degrees of severity of the condition on the APACHE II objectification scales (< 20) and SAPS (< 11) and the level of IL-6 concentration in the blood serum up to 100 pg/ml - extended pathogenetically determined, radical surgical interventions; – in the 3rd degree of severity of the condition on the APACHE II objectification scales (>20) and SAPS (> 11) and the level of IL-6 concentration in the blood serum of more than 100 pg/ml - a minimum, palliative volume of surgery, which allows you to eliminate the phenomena of GKN. Laparoscopically assisted surgery – left-sided Hemicolectomy, sigmoid colon resection, anterior rectal resection: are optimal, which promotes early recovery of intestinal peristalsis and early activation of patients, as well as reduces postoperative bed-day.