RADICAL SURGERY IN THE MANAGEMENT OF LARGE BOWEL OBSTRUCTION OF TUMOR ETIOLOGY

Abstract

This article analyzes the immediate results of radical surgical treatment in 193 patients with acute large bowel obstruction of tumor etiology, treated between 2000 and 2022. The study highlights the importance of a differentiated surgical approach based on tumor localization and the patient's condition. For right-sided tumors, right hemicolectomy with ileotransverse anastomosis was performed. For left-sided lesions, options included the Hartmann procedure, left hemicolectomy with primary anastomosis, or subtotal colectomy, depending on the degree of colonic wall changes. Intraoperative antegrade decompression techniques are described, facilitating one-stage resection with primary anastomosis even in left-sided obstructions. Postoperative mortality was 16%, primarily associated with delayed intervention in elderly patients. The findings advocate for primary radical surgery aimed at both relieving obstruction and removing the tumor, accompanied by mandatory nasogastric and transanal decompression.