CLINICAL EVALUATION OF A MODIFIED METHOD OF LOW MANUAL PROCESSING OF THE DUODENAL STUMP IN PALLIATIVE GASTIRECTOMY
Abstract
Objective: To develop a method of low manual processing of the duodenum when the tumor of the stomach passes to the wall of the duodenum. Material and methods: A retrospective analysis of the results of processing the duodenal stump was carried out in 46 patients with stage III-IV locally advanced gastric cancer who underwent standard and palliative gastrectomy for the period from 2012 to 2021 in the department of thoracoabdominal surgery, Samarkand branch of RSSPMCO and R. All patients underwent combined gastrectomy with planar resection and thermoelectrocoagulation of areas of growth of the stomach tumor into the head of the pancreas for gastric cancer with the transition to the duodenum. Depending on the method, the treatment of the stump is 12 p.k. the patients were divided into two groups. In the 1st group - 31 (67.39%) patients, the duodenal stump was sealed manually, and in the second group, 15 (32.60%) patients had the duodenal stump mechanically sealed using the UO-40 apparatus and due to partial The defect of the stump was additionally sutured manually. Results: Our studies have shown that the incidence of duodenal stump suture failure in patients after gastrectomy with the tumor moving into the proximal part of the duodenum with the manual method was 6.4% (2 patients). With the combined method, stump failure was noted in 1 (6.6%) patient. Conclusions: The proposed method of processing the duodenal stump is quite simple, hermetic, which can be recommended for a wide surgical practice.