vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-2-207-214vestim-433Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEКОМБИНИРОВАННЫЕ ОПЕРАЦИИ У ПАЦИЕНТОВ С РЕЗЕКТАБЕЛЬНЫМ РАКОМ ЖЕЛУДКАCOMBINED OPERATIONS IN PATIENTS WITH RESECTABLE GASTRIC CANCERРевтовичМ. Ю.ReutovichM. Yu.

Ревтович Михаил Юрьевич – канд. мед. наук, доцент. 

223040, агр. Лесной, Минский р-н.

Mikhail Yu. Reutovich – Ph. D. (Med.), Assistant Professor. 

223040,  Lesnoy, Minsk region.

mihail_revtovich@yahoo.comСуконкоО. Г.SukonkoO. G.

Суконко Олег Григорьевич – д-р мед. наук, профессор, директор. 

223040, агр. Лесной, Минский р-н.

Oleg G. Sukonko – D. Sc. (Med.), Professor, Director.  

223040,  Lesnoy, Minsk region.

OncoBel@omr.med.byШмакА. И.ShmakA. I.

Шмак Андрей Иванович – д-р мед. наук, заведующий  лабораторией. 

223040, агр. Лесной, Минский р-н.

Andrei I. Shmak – D. Sc. (Med.), Head of the Laboratory. 

223040,  Lesnoy, Minsk region.

smak.ai@tut.byКраськоО. В.KraskoV. V.

Красько Ольга Владимировна – канд. техн. наук,  доцент, вед. науч. сотрудник. 

ул. Сурганова, 6,  220012,  г. Минск.

Volha V. Krasko – Ph. D. (Tech.), Assistant Professor,  Leading researcher.

6, Surganov  Str., 220012, Minsk.

krasko@newman.bas-net.byРеспубликанский научно-практический центр онкологии и медицинской радиологии им. Н. Н. Александрова.N. N. Alexandrov National Cancer Centre.Объединенный институт проблем информатики НАН Беларуси.United Institute of Informatics Problems of the National Academy of Sciences of Belarus.201825062018152207214Copyright © Ревтович М.Ю., Суконко О.Г., Шмак А.И., Красько О.В., 20182018Ревтович М.Ю., Суконко О.Г., Шмак А.И., Красько О.В.Reutovich M.Y., Sukonko O.G., Shmak A.I., Krasko V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/433

Проведен анализ отдаленных результатов лечения 1065 радикально оперированных по поводу рака  желудка (РЖ) пациентов, у 103 выполнены комбинированные операции. Установлено статистически значимое влияние характера выполненной операции на количество послеоперационных осложнений (4,9 % после комбинированных  операций, 1,1–3,4 % после стандартных) и частоту прогрессирования РЖ (39,8 % после комбинированных операций,  17,8–30,1 % после стандартных). Отмечено превалирование в структуре прогрессирования перитонеальной диссеминации, 4-летняя кумулятивная инцидентность которой после комбинированных операций составила 41,1 ± 0,3 %,  а после стандартных варьировалась от 13,26 ± 0,02 до 27,27 ± 0,07 %. Последнее свидетельствует об относительной  радикальности хирургического лечения при выходе опухоли за пределы желудочной стенки, что требует применения  адъювантного лечения, направленного на профилактику прогрессирования РЖ, прежде всего сопровождающегося  диссеминированным поражением брюшины.

The analysis of the long-term results of treatment of 1065 radically operated gastric cancer patients was carried out. 103 of them underwent combined operations. A statistically significant effect of the nature of the operation performed on the number of postoperative complications (4.9 % after combined operations, 1.1–3.4 % after standard operations)  and the incidence of disease progression (39.8 % after combined operations, 17.8–30.1 % after standard operations). Prevalence in the structure of the progression of peritoneal dissemination was noted, the 4-year cumulative incidence of which after  combined operations was 41.1 ± 0.3 % and after standard operations – from 13.26 ± 0.02 to 27.27 ± 0.07 %. The latter testifies  to a relative radical surgical treatment when a tumor leaves the gastric wall, which requires the use of adjuvant treatment  aimed at preventing the progression of gastric cancer, primarily with disseminated peritoneal lesions.

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