Осложненные формы рака желудка — современные подходы к лечению

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Из общего числа пациентов с раком желудка 40% госпитализаций происходят в результате осложнений. Наиболее частым осложнением рака желудка являются кровотечение (22—80%), прогрессирующий опухолевый стеноз (26—60%) и перфорация (<5%). Основными методами лечения рака желудка, осложненного кровотечением, являются различные формы эндоскопического гемостаза, трансартериальная эмболизация сосудов, питающих опухоль, внешняя паллиативная лучевая терапия. В случае неэффективности возможно хирургическое лечение, алгоритм которого не стандартизирован. При развитии злокачественного стеноза выходного отдела желудка применяются декомпрессионные методы: эндоскопическое стентирование опухолевого канала, формирование паллиативного гастроэнтероанастомоза. Кроме того, возможно и хирургическое лечение в объеме гастрэктомии, проксимальной или дистальной резекции желудка. Основной проблемой пациентов с осложненными формами рака желудка является отсутствие стандартизированных алгоритмов и обилие хирургических техник, которые могут быть применены. Цель нашего обзора — систематизация имеющихся данных в отношении лечения пациентов с осложненными формами рака желудка и стандартизация существующих методик.

Ключевые слова:

рак желудка

кровотечение

стеноз

эндоскопический гемостаз

гастроэнтероанастомоз

эндоскопическое стентирование

гастрэктомия

Авторы:

Тарасов С.А.

ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения города Москвы»

ORCID: 0000-0002-9173-6296

Ярцев П.А.

SPIN РИНЦ: 4044-9661
Scopus AuthorID: 55970485700
ResearcherID: P-9151-2017
ORCID: 0000-0003-1270-5414

Рогаль М.М.

SPIN РИНЦ: 4591-3844
Scopus AuthorID: 57022352600
ResearcherID: M-2090-2018
ORCID: 0000-0003-1327-6973

Аксенова С.О.

ORCID: 0009-0008-5623-6094

Дата поступления:

17.09.2023

Дата принятия в печать:

30.09.2023

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