rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2410-1893-2022-9-4-1rpmj-786Research ArticleОригинальные статьи. Онкология, лучевая терапияOriginal Articles. ОncologyСравнительная оценка результатов выполненных D2 и D3 лимфодиссекций в хирургии рака ободочной кишкиComparative assessment of results of D2 and D3 lymph node dissections in term of colon cancer surgeryhttps://orcid.org/0000-0003-3061-6108КитО. И.KitO. I.

Кит Олег Иванович – академик РАН, доктор медицинских наук, профессор, генеральный директор

Ростов-на-Дону

SPIN: 1728-0329,

AuthorID: 343182,

ResearcherID: U-2241-2017,

Scopus Author ID: 55994103100

Oleg I. Kit – academician of the Russian Academy of Sciences, Dr. Sci. (Med.), professor, general director

Rostov-on-Don

SPIN: 1728-0329,

AuthorID: 343182,

ResearcherID: U-2241-2017,

Scopus Author ID: 55994103100

rnioi@list.ruhttps://orcid.org/0000-0002-3561-098XДженковаЕ. А.DzhenkovaE. A.

Дженкова Елена Алексеевна – доктор медицинских наук, доцент, ученый секретарь

Ростов-на-Дону

SPIN: 6206-6222,

AuthorID: 697354,

ResearcherID: K-9622-2014,

Scopus Author ID: 6507889745

Elena A. Dzhenkova – Dr. Sci. (Biol.), academic secretary

Rostov-on-Don

SPIN: 6206-6222,

AuthorID: 697354,

ResearcherID: K-9622-2014,

Scopus Author ID: 6507889745

rnioi@list.ruhttps://orcid.org/0000-0002-0328-9714МирзоянЭ. А.MirzoyanE. A.

Мирзоян Эллада Арменовна – аспирант

344037, г. Ростов-на-Дону, ул. 14-я линия, д. 63

SPIN: 2506-8605,

AuthorID: 1002948,

ResearcherID: AAZ-2780-2021,

Scopus Author ID: 57221118516

Ellada A. Mirzoyan – PhD student

63 14 line str., Rostov-on-Don 344037

AuthorID: 1002948,

ResearcherID: AAZ-2780-2021,

Scopus Author ID: 57221118516

ellada.mirzoyan@yandex.ruhttps://orcid.org/0000-0003-1957-7363ГеворкянЮ. А.GevorkyanYu. A.

Геворкян Юрий Артушевич – доктор медицинских наук, профессор, заведующий отделением абдоминальной онкологии № 2

Ростов-на-Дону

SPIN: 8643-2348,

AuthorID: 711165

Yuriy A. Gevorkyan – Dr. Sci. (Med.), professor, head of the department of abdominal oncology No. 2

Rostov-on-Don

SPIN: 8643-2348,

AuthorID: 711165

ellada.mirzoyan@yandex.ruhttps://orcid.org/0000-0001-9749-709XКолесниковЕ. Н.KolesnikovE. N.

Колесников Евгений Николаевич – доктор медицинских наук, заведующий отделением абдоминальной онкологии № 1 с группой рентгенэндоваскулярных методов диагностики и лечения

Ростов-на-Дону

SPIN: 8434-6494,

AuthorID: 347457

Evgeniy N. Kolesnikov – Dr. Sci. (Med.), head of department of abdominal oncology No. 1 with a group of roentgen endovascular methods of diagnostics and treatment

Rostov-on-Don

SPIN: 8434-6494,

AuthorID: 347457

ellada.mirzoyan@yandex.ruhttps://orcid.org/0000-0003-3998-8004СнежкоА. В.SnezhkoA. V.

Снежко Александр Владимирович – доктор медицинских наук, хирург отделения абдоминальной онкологии № 1

Ростов-на-Дону

SPIN: 2913-3744,

AuthorID: 439135,

Scopus Author ID: 6701854863

Aleksandr V. Snezhko – Dr. Sci. (Med.), MD, surgeon at the abdominal oncology department No. 1

Rostov-on-Don

SPIN: 2913-3744,

AuthorID: 439135,

Scopus Author ID: 6701854863

ellada.mirzoyan@yandex.ruФГБУ «НМИЦ онкологии» Минздрава РоссииРоссияNational Medical Research Centre for OncologyRussian FederationФГБУ "НМИЦ онкологии" Минздрава России г. Ростов-на-ДонуРоссияNational Medical Research Centre for OncologyRussian Federation202201122022941017Copyright © Кит О.И., Дженкова Е.А., Мирзоян Э.А., Геворкян Ю.А., Колесников Е.Н., Снежко А.В., 20222022Кит О.И., Дженкова Е.А., Мирзоян Э.А., Геворкян Ю.А., Колесников Е.Н., Снежко А.В.Kit O.I., Dzhenkova E.A., Mirzoyan E.A., Gevorkyan Y.A., Kolesnikov E.N., Snezhko A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/786Цель исследования

Цель исследования. Провести оценку общей выживаемости больных после выполненных стандартной и расширенной лимфодиссекций (D2- и D3‑лимфодиссекций соответственно) при раке ободочной кишки (РОК) и оценить частоту послеоперационных осложнений и динамику послеоперационного восстановления.

Материалы и методы

Материалы и методы. В исследование включены 50 больных РОК в возрасте от 39 до 84 лет.

Результаты

Результаты. Для сравнительной оценки общей выживаемости, частоты послеоперационных осложнений и динамики послеоперационного восстановления пациенты были разделены на 2 группы в зависимости от объема лимфодиссекции. 1‑ая группа – 23 пациента (46 %), которым была выполнена D2 лимфодиссекция, 2‑ая – 27 (54 %), которым были выполнены оперативные вмешательства с D3 лимфодиссекцией. В раннем послеоперационном периоде у 8 (16 %) больных развились осложнения. По классификации Clavien-Dindo у 5 пациентов из 1‑ой группы возникли хирургические осложнения I степени, у одного – III b степени. У 2 пациентов из 2‑ой группы– осложнения III b степени. Достоверных различий между группами по времени появления перистальтики, газов и стула, начало приема жидкостей и пищи не обнаружено. Выявлено достоверное увеличение продолжительности пребывания после выявленных открытых операций по сравнению с группой пациентов, у которых использовался лапароскопический доступ. При оценки общей выживаемости в двух сравниваемых группах не было выявлено статистически значимых различий (p = 0,918).

Заключение

Заключение. Таким образом, частота послеоперационных осложнений, требующих повторного хирургического вмешательства, после выполнения D3 лимфодиссекции была сопоставима со сравниваемой группой. Выполнение хирургического вмешательства с D3 лимфодиссекцией не повлияло на динамику послеоперационного восстановления и на общую выживаемость пациентов.

Purpose of the study

Purpose of the study. Was to evaluate overall survival of CC patients after D2 and D3 lymph node dissections and assess the frequency of postoperative complications and dynamics of postoperative recovery.

Materials and methods

Materials and methods. The study included 50 CC patients aged 39–84 years.

Results

Results.  The comparative assessment of the overall survival, frequency of postoperative complications and dynamics of postoperative recovery was performed in patients divided into 2 groups depending on the lymph node dissection extent. Group 1 included 23 patients (46 %) with D2 lymph node dissection, group 2–27 patients (54 %) with D3 lymph node dissection. 8 (16 %) patients developed complications in the early postoperative period. Patients in group 1 had grade I (5 patients) and grade IIIb (1 patient) surgical complications, according to the Clavien-Dindo classification. 2 patients in group 2 developed grade III b complications. No significant differences were found between groups in peristalsis, gases and bowel movement, starting eating and drinking. A significant increase in the number of postoperative bed-days was observed in patients who underwent open surgery, compared with the group with laparoscopic access. No statistically significant difference was found in the overall survival in patients of the two groups (p = 0.918).

Conclusion

Conclusion. The rates of postoperative complications that required repeated surgery were comparable between the groups with D2 and D3 lymph node dissections. D3 lymph node dissection did not affect the dynamics of postoperative recovery and the overall survival of patients.

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