gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1457Research ArticleНОВОСТИ КОЛОПРОКТОЛОГИИNEWS OF COLOPROCTOLOGYЭкстирпация прямой кишки по поводу рака у больного с декомпенсированным циррозом печени и портальной гипертензиейExtirpation of rectum for cancer in patient with decompensated liver cirrhosis and portal hypertensionЦарьковП. В.TsarkovP. V.ЛебезевВ. М.LebezevV. M.СтамовВ. И.StamovV. I.НикодаВ. В.NikodaV. V.КравченкоА. Ю.KravchenkoA. Yu.ЛюбивыйЕ. Д.LyubivyYe. D.БашанкаевБ. Н.BashankayevB. N.ДаниловМ. А.DanilovM. A.2011120920112158289Copyright © Царьков П.В., Лебезев В.М., Стамов В.И., Никода В.В., Кравченко А.Ю., Любивый Е.Д., Башанкаев Б.Н., Данилов М.А., 20112011Царьков П.В., Лебезев В.М., Стамов В.И., Никода В.В., Кравченко А.Ю., Любивый Е.Д., Башанкаев Б.Н., Данилов М.А.Tsarkov P.V., Lebezev V.M., Stamov V.I., Nikoda V.V., Kravchenko A.Y., Lyubivy Y.D., Bashankayev B.N., Danilov M.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1457

Цель публикации. Оценить эффективность мультидисциплинарного подхода в лечении больных раком прямой кишки, сочетающимся с портальной гипертензией и циррозом печени на примере клинического наблюдения.Основные положения. Больному 71 года (диагностированы рак нижнеампулярного отдела прямой кишки и сопутствующие заболевания – декомпенсированный цирроз печени, портальная гипертензия с варикозным расширением вен пищевода и желудка, печеночно-клеточная недостаточность класса С по классификации Чайлда–Пью) выполнена одномоментная брюшно-промежностная экстирпация прямой кишки с парааортальной лимфаденэктомией, формированием концевой забрюшинной колостомы, спленэктомией, деваскуляризацией желудка, гастротомией с прошиванием варикознорасширенных вен нижней трети пищевода и желудка. На основе зарубежного опыта проанализированы риски подобных хирургических вмешательств и, основываясь на успешном клиническом наблюдении, предлагается оптимальная концепция хирургического лечения больных данной категории.Заключение. Мультидисциплинарный подход в условиях многопрофильной клиники позволяет обеспечить адекватное лечение больных раком прямой кишки, сочетающимся с портальной гипертензией и циррозом печени.

The aim of publication

The aim of publication. To estimate efficacy of multidisciplinary approach in treatment of patients with rectal cancer together with portal hypertension and liver cirrhosis using the example of clinical case.

Original positions

Original positions. 71 year-old male patient with diagnosed low rectal cancer and concomitant: decompensated liver cirrhosis, portal hypertension with varicose esophageal and stomach veins and hepatocellular failure of class C by Child-Pugh. Patient was treated by simultaneous abdomino-perineal rectal excision with para-aortic lymphadenectomy and retroperitoneal end colostomy, splenectomy, devascularization of the stomach, gastrotomy with stitching of varicose veins at the lower third of the esophagus and the stomach. On the basis of foreign experience, risks of such surgical interventions were analyzed and, based on current clinical case, optimal surgical concept for patients of this category is proposed.

Conclusion

Conclusion. Multidisciplinary approach in diversified clinic allows to provide adequate treatment of patients with cancer of the rectum combined with portal hypertension and liver cirrhosis.

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The authors declare that there are no conflicts of interest present.