Acute intestinal tumor obstruction: contradictions of tactics and ways to improve results

Objective. To identify ways to improve the treatment outcomes of patients with acute obstructive intestinal tumor obstruction in an on-call surgical hospital. Materials and methods. By design, the study is a non-randomized, retrospective multicenter analysis. The object of the study was 1,571 patients who underwent emergency surgery in surgical departments of the Samara region for acute intestinal obstruction of tumor origin with tumor localization in the left half of the colon. The analysis of the immediate and long-term treatment results was carried out. Results. It is necessary to change the principles of the organization of oncological care in terms of reducing the time of preoperative examination, the fastest examination at the stage of treatment at the oncological dispensary. On the other hand, a possible solution to this problem may be primary resection based on the oncological principle with the removal of a single-barrel colostomy in an urgent surgical hospital. This will allow the patient, even in case of a delay in admission to the oncological dispensary, to get a time reserve and reduce the frequency of complications from intestinal stoma. Conclusions. Proximal double-barrelled colostomy remains the leading intervention aimed at resolving intestinal obstruction in patients with tumors of the descending colon and sigmoid colon, even in the patient's operability. The principles of organizing oncological care for patients discharged with colostomy from an on-call surgical hospital and referred for radical surgery need to be reviewed in terms of speeding up hospitalization and continuity of specialized care.