RU2271750C1 - Method for treating perforation in case of infiltrative gastric cancer - Google Patents

Abstract

FIELD: medicine, oncology.

SUBSTANCE: in case of perforation-complicated gastric cancer one should apply four mucous-muscular sutures through perforation foramen upon posterior gastric wall in projection of perforation foramen. Then on should suture the edge of perforation foramen with the same ligatures. Moreover, it is necessary to capture tumor tissues along 1 cm, not less. Ligatures should be applied through all the layers of anterior abdominal wall in projection of perforation foramen, ligatures should be bound on skin. The innovation enables to obdurate tumor perforation in case of either impossibility to suture the foramen in or remove the tumor.

EFFECT: higher efficiency of therapy.

1 ex

Description

The invention relates to medicine, namely to oncology, and can be used to treat complications of generalized cancer of the stomach.

A known method of treating a perforated tumor of the stomach, which consists in suturing the perforation with two rows of sutures (Lisitsin K.M., Revskoy A.K. "Emergency surgery for oncological diseases of the abdominal cavity." M .: Medicine, 1986, S. 37).

The method has a significant drawback. The method does not allow reliably suturing the perforated hole with locally advanced cancer of the stomach.

As a prototype, a method of treating a perforated tumor of the stomach was selected, which consists in gastrectomy (Sidorenko Yu.S. "Essays on Emergency Oncology" Rostov-on-Don: Publishing House of the Pedagogical University, 1997, p.105).

The method has a significant drawback. The method is not applicable in cases where there is an unresectable locally advanced tumor of the stomach, which cannot be removed.

The aim of the invention was a reliable obstruction of the perforation of a tumor of the stomach when it is impossible to suture the opening by tightening the tissue of the wall of the stomach or by removing the tumor.

This goal is achieved by the fact that they do not remove the stomach, through the perforation hole, put muscular-muscular sutures on the posterior wall of the stomach in the projection of the perforation number four, stitch the edge of the perforation hole with the same ligatures, capture the tumor tissue for at least one centimeter, conduct ligatures through all layers of the anterior abdominal wall in the projection of the perforation hole on the skin, ligatures are tightened on the skin.

The novelty of the invention lies in the fact that the perforation of the tumor of the stomach is reliably obstructed due to the imposition of mucus-muscular sutures on its posterior wall, which are displayed on the skin in the projection of perforation.

Known sources of information from the CIS and foreign countries do not contain a similar method for treating perforation in case of infiltrative gastric cancer.

"A method for the treatment of perforation in infiltrative cancer of the stomach" can be applied in general surgical and specialized oncology hospitals.

The method is as follows.

Perform laparotomy. Through the perforation, mucus-muscular sutures are placed on the posterior wall of the stomach in the projection of the perforation number four. The edge of the perforation hole is stitched with the same ligatures, capturing the tumor tissue for at least one centimeter. Ligatures are passed through all layers of the anterior abdominal wall in the projection of the perforation hole onto the skin. Ligatures tighten on the skin.

Example:

Patient K-s, 74 years old, no. disease 2316 / s, entered the Rostov Cancer Research Institute on September 20, 2003 with a clinic of diffuse purulent peritonitis. Previously, a patient underwent fibrogastroscopy at the place of residence, which was diagnosed with a tumor of the stomach body. According to emergency indications, the patient was taken to the operating room. When laparotomy revealed an infiltrative tumor of the stomach body, multiple liver metastases, perforation of the tumor of the stomach body measuring 2 by 3 cm, diffuse purulent peritonitis. Through the perforation hole, musculoskeletal sutures were placed on the posterior wall of the stomach in the projection of the perforation number four. We stitched the edge of the perforation hole with the same ligatures, capturing the tumor tissue for at least one centimeter. Ligatures were passed through all layers of the anterior abdominal wall in the projection of the perforation hole onto the skin. Ligatures tightened on the skin. The abdominal cavity was drained with silicone tubes.

The technical and economic efficiency of the method lies in the fact that with perforations of locally distributed infiltrative tumors of the stomach, it is possible to reliably suture the hole, which helps to save the patient's life, improves his quality of life.

Claims (1)

A method for treating perforation in infiltrative gastric cancer, characterized in that four mucus-muscular sutures are placed on the posterior wall of the stomach through the perforated hole in the projection of the perforated hole, the edge of the perforated hole is stitched with the same ligatures, capturing tumor tissue for at least 1 cm, ligatures are performed through all layers of the anterior abdominal wall in the projection of the perforated hole and tightened on the skin.