Authors
Semionkin E.I.1, Lukanin R.V.2, Bragina I.Yu.2, Snegur S.V.2, Yudina E.A.2, Krotkov A.R.2
1 Ryzan State Medical University,Ryazan
2 Ryazan StateClinical Hospital, Ryazan
Abstract
Aim. Present two clinical cases primary-multiplie synchronous of cancer.
Patients and methods. The results of the examinations and surgical treatment of a patient 67 year old , which has studied a diagnosis of primary — multiplie synchronous cancer: adenocarcinoma of the stomach, a low — differentiated adenocarcinoma of the left flexure of the colon, neuroendocrine tumor of the small intestines, the patient of 68 year old with a diagnosis of primary-multiplie cancer of the large intenstine, which has 3 tumors: the moderately differentiated adenocarcinoma of caecum, moderately differentiated adenocarcinoma of the colon, T2 adenocarcinoma in situ colon polyp Tis, the patient of 63 year old, which has a diagnosis : adenocarcinoma of ascending colon and of descending colon and the last patient, this is patient 75 year old, which has diagnosis : adenocarcinoma of ascending colon and neuroendocrine tumor of the descending colon.
Results. Our observation confirms the opinion of other authors about the need for colonoscopy in patients with gastric cancer, given the prevalence of tumors of this localization, as well as the possibility of synchronous tumor damage not only to the large intenstine and stomach, but also to the small intenstine and the possibility of the presence of three tumors (adenocarcinomes) in the colon. For the diagnosis of colon tumors, the most informative method in endoscopy, this is confirmed by the second clinical observation. There are no clear guidelines for the treatment of synchronous cancer. Some prefer radical surgery with and without chimiotherapy for resectable primary-multiplie synchronous neopkasms, others suggest a more conservative approach, especially for the elderly. The choice of the right treatment tactics and its individualization using modern minimally invasive technologies is the main successful treatment of primary- multiplie cancer.
Conclusion. In our opinion, the volume of surgical intervention. It should be decided individually, depending on the condition of the patient, possibility of expanding operations. Patients with colon cancer need to carry out esophagogastroduodenoscopy in the preoperative period, which helps to identify synchronous stomach cancer. Colonoscopy is the main method of examination of the colon.
The possibility of synchronous tumor damage not only the colon and the stomach, but also the small intestine, which is a rare localization Education requires a thorough review of the abdominal cavity during surgery and available methods examination of the small intestine before surgery.
Keywords: primary-multiple synchronous colorectal cancer Gut, stomach, small intestine, diagnosis, treatment.
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