Using two-stage cytoreductive surgery in a patient with complicated progressive small intestinal cancer

The article presents a clinical observation of a patient with an aggressive (proliferative activity index Ki67 - 70%) form of small intestine cancer (SIC). After the diagnosis was established in 2017, the patient underwent radical (April 2017) and cytoreductive (February 2019) surgical interventions with postoperative intra-abdominal normothermic chemoperfusion at the oncology center, as well as systemic chemotherapy for 3 years. Despite the complex treatment, due to the unfavorable biological properties of the tumor, the progression of the oncological process in the form of peritoneal carcinomatosis was stated. Against the background of ongoing systemic chemotherapy, the patient developed life-threatening complications - a violation of the small intestine patency of carcinomatous genesis and necrosis of recurrent tumor nodes. The severity of the clinical situation determined the necessity of using cytoreductive technologies in the provision of surgical care in a multidisciplinary emergency hospital. The article describes in detail the tactics of complex treatment of a patient with advanced complicated small intestine cancer, discusses the indications for surgical treatment, its volume and stages, as well as evaluates immediate and long-term outcomes.