gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2025-24-1-135-144gnck-1997Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWХирургическая тактика при острой обтурационной непроходимости опухолевого генеза у больных пожилого и старческого возраста (обзор литературы)Surgical approach for acute colon tumor obstruction in elderly and octogenarian patients (review)ЭфронА. Г.EfronA. G.

Эфрон Александр Григорьевич — научный сотрудник НИЦ; главный врач

ул. Крупской, д. 28, г. Смоленск, 214019 

ул. Маршала Жукова, д. 19, г. Смоленск, 214000 

Aleksandr G. Efron 

Krupskaya st., 28, Smolensk, 214019 

Marshal Zhukov st., 19, Smolensk 214000 

https://orcid.org/0000-0002-1832-5255ЩаеваС. Н.ShchaevaS. N.

Щаева Светлана Николаевна — д.м.н., доцент по специальности «Хирургия», заведующая кафедрой факультетской хирургии; врач-хирург, онколог

ул. Крупской, д. 28, г. Смоленск, 214019 

ул. Маршала Соколовского, д. 18/1, г. Смоленск, 214031, +79107132726 

Svetlana N. Shchaeva 

Krupskaya st., 28, Smolensk, 214019 

Marshal Sokolovsky st., 18/1, Smolensk, 214031 

facul.hir.conferens@yandex.ruhttps://orcid.org/0000-0001-8351-9163ВолынецЛ. И.VolynetsL. I.

Волынец Лариса Исаковна — к.м.н., доцент кафедры факультетской хирургии; главный врач

ул. Крупской, д. 28, г. Смоленск, 214019 

ул. Маршала Жукова, д. 19, г. Смоленск, 214000 

Larisa I. Volynets 

Krupskaya st., 28, Smolensk, 214019 

Gagarin st., 27, Smolensk, 214018 

ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России ; ОГБУЗ «Смоленский областной онкологический клинический диспансер»РоссияSmolensk State Medical University ; Smolensk Regional Oncology Clinical HospitalRussian FederationФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России ; Многопрофильная клиника ООО «Уромед»РоссияSmolensk State Medical University ; Multidisciplinary clinic “Uromed”Russian FederationФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России ; ОГБУЗ «Смоленская областная клиническая больница»РоссияSmolensk State Medical University ; Smolensk Regional Clinical HospitalRussian Federation202521032025241135144Copyright © Эфрон А.Г., Щаева С.Н., Волынец Л.И., 20252025Эфрон А.Г., Щаева С.Н., Волынец Л.И.Efron A.G., Shchaeva S.N., Volynets L.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1997

Острая обтурационная непроходимость является наиболее частым осложнением рака левой половины ободочной кишки, причем возраст пациентов с данной патологией в большинстве случаев составляет 75 лет и старше. Оптимальная хирургическая тактика у этой группы пациентов до сих пор остается дискутабельной. В базах данных Elibrary.ru, PubMed, Medline был проведен поиск научных исследований по лечению левосторонней толстокишечной непроходимости опухолевой этиологии у больных пожилого и старческого возраста в период с 2008 по 2023 гг. До настоящего времени отсутствуют неопровержимые доказательства в поддержку того, что экстренная операция или стентирование являются оптимальными методами лечения с точки зрения развития послеоперационных осложнений, летальности и отдаленных онкологических результатов. Актуальным решением проблемы экстренного хирургического лечения рака левой половины ободочной кишки, осложненного острой кишечной непроходимостью у пациентов пожилого и старческого возраста, могут быть методы временной декомпрессии ободочной кишки. Проведенный анализ указывает на преимущества формирования декомпрессионной колостомы на первом экстренном этапе в лечении обструктивного рака левой половины ободочной кишки у пациентов пожилого и старческого возраста, так как данный подход сопровождается снижением периоперационной летальности, улучшением качества жизни за счет снижения потребности в постоянных стомах, хорошими отдаленными онкологическими результатами — показателями 3-х летней общей выживаемости.

Acute bowel obstruction is the most common complication of left colon cancer, with the age of patients with this pathology in most cases being over 75 years. The optimal surgical approach in this group of patients remains debatable. A search of scientific studies on the treatment of left-sided malignant obstruction in elderly and octogenarian patients was done in the Elibrary.ru, PubMed, and Medline databases from 2008 to 2023. To date, there is no irrefutable evidence to support whether emergency surgery or colonic stent placement is optimal treatment in terms of the morbidity, mortality and late oncological outcomes. A current solution to the problem can be temporary decompression of the bowel. The literature demonstrates advantages of diverting colostomy at the first stage in decrease in perioperative mortality, an improvement in the quality of life due to a decreased morbidity and mortality rate, good oncological.

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