International Medical Journal, Vol. 20., Iss. 3, 2014, P. 63−66.
Early diagnosis of postoperative septic complications in patients with rectal cancer
V. T. Zaitsev Institute of General and Urgent Surgery (National Academy of Medical Sciences of Ukraine), Kharkiv, Ukraine
Timely diagnosis and treatment of rectal cancer is urgent due to a steady growth in the number of the disease cases. Increase of the number of sphincter−preserving surgery (52−87 % cases) is a typical tendency of the modern surgery for colorectal cancer. Among post−operative complications a significant place is occupied by purulent ones responsible for 12−67 % of cases. These complications are the most common cause of death in early post−operative period. High incidence of purulent complications stimulates search for the causes as well as their prevention and treatment. The analysis of the treatment outcome of 124 patients with rectal cancer demonstrated that a series of diagnostic measures allows to make a correct diagnosis within a short period of time. The complex of measures included laboratory diagnosis of intoxication parameters, urinalysis, x−ray (plain radiography of the abdominal cavity). X−ray contrast investigation of the rectum was performed to exclude anastomosis failure after transabdominal resection and abdominoanal resection, fistulography was performed to reveal fistulas of the rectum after abdominoanal surgery, the number of fistulas. Ultrasouography and CT of the abdominal cavity and small pelvis were used to reveal anastomosis failure, exclude intraabdominal and retroabdominal abscesses, phlegmons of the small pelvis, and retroperitoneal space as well as when peritonitis was suspected. The program of monitoring with the use of the methods of early diagnosis of post−operative complications allowed 2−fold reduction of the diagnostic period from the moment of the complication development to the onset of therapy, which promoted reduction of general mortality from 18.2 to 8.2 %.
Key words: colorectal cancer, septic complications, diagnostic period.