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№1' 2016
SURGERYInternational Medical Journal, Vol. 22., Iss. 1, 2016, P. 35−37.
SURGICAL TREATMENT OF PELVIC TUMORS WITH INVASION OF THE VASCULAR FORMATIONS
V. T. Zaytsev Institute of General and Emergency Surgery, Ukraine
The purpose of the work was to assess the effectiveness of combined extensive operations in locally advanced cancers of pelvis organs. The results of surgical treatment of 21 patients (9 men, 12 women), aged 44−69 with locally advanced malignant tumors of the small pelvis treated at V. T. Zaytsev Institute of General and Emergency Surgery, National Academy of Medical Science of Ukraine were analyzed. Sixteen cases (76.2 %) had colon cancer with invasion to adjacent organs (the posterior wall of the bladder −− 5 cases, the uterus −− 4 cases, and in the prostate and vagina −− 4 cases, ureters −− cases), 3 cases (14.3 %) had multiple primary malignant tumors (in combination with bladder cancer in two cases, in combination with endometrial cancer in 1 case), 2 cases (9.5 %) had sarcoma of the pelvis. To clarify the diagnosis, the following methods were used: ultrasound, multislice computed tomography, MRI, pelvic videocolonoscopy, cystoscopy, angiography, histologic and clinical tests. All patients were performed advanced surgery for absolute indications. Postoperatively standard therapy was administered: antibiotic prevention, correction of fluid and electrolyte content and protein metabolism (infusion−transfusion therapy), anticoagulant therapy, pain relief. Postoperative surgical complications occurred in 7 cases (33.3 %), which required reoperation in 4 cases (19.0 %). Overall and disease−free 2−year survival rate in cases of tumor spread to adjacent organs was 75 % and 56.3 %, respectively; in cases of multiple primary tumors at time of observation > 24 months relapses and deaths were not observed; in the case of extraorgan sarcomas local recurrences occurred within 1 year, with the mortality rate of disease progression at 6 and 15 months after the operation. Active surgical tactics aimed at curative treatment, allows even at the tumor invasion to the great vessels, to prevent further progression of the disease, thus, extend the life of patients. Treating common pelvic tumors requires major surgery with multidisciplinary team of surgeons. Despite the trauma, interventions with adequate provision of the perioperative period give satisfactory results. Long−term results allow considering these operations a method of choice for locally advanced pelvic tumors. Further study of the long−term results of surgical treatment will allow understanding the possibility of cure in these patients.
Key words: small pelvis tumors, vessels, surgical treatment.