Abstract
Object. Determining the degree of influence of exacerbation of somatic pathology on the shift of the terms of surgical treatment in patients with spinal metastases.
Methods. A retrospective analysis of the data of 210 patients with spinal neoplasms undergoing treatment in the period from 2013 to 2017 was performed. In this cohort, the average terms from the moment of determining the indications for surgical treatment to surgery, as well as the frequency of somatic pathology, which was a contraindication to surgical treatment, were analyzed
Results. The average time from the moment of determining the indications for surgical treatment to surgery in the main cohort of patients was 46.4 days (12 - 86). An aggravation of the gastrointestinal tract pathology with the formation of ulcers or erosion of the stomach and duodenum was the most common cause of delayed surgical treatment (41%). At the same time, 86% of cases of this complication led to a shift in the timing of surgery to 1 month. The presence of foci of chronic infection statistically significantly determined the greatest duration of the preoperative period (> 1 month) in 52.6% of cases.
Conclusion. An aggravation of the gastrointestinal tract pathology and the presence of foci of chronic infection in patients with metastatic spinal lesions are the most frequent contraindications to surgical treatment and the reasons for the increase in the duration of the preoperative period.
References
Белова Е.Б. Эрозии желудка и двенадцатиперстной кишки: некоторые аспекты патогенеза и дифференцированной терапии: Автореф. дис. ... д-ра мед. наук. Ижевск, 2006.
Григорьевская З.В., Петухова И.Н., Багирова Н.С. и др. Нозокомиальные инфекции у онкологических больных: проблема нарастающей резистентности грамотрицательных микроорганизмов Сибирский онкологический журнал. 2017;16(1):9197.
Заборовский Н.С., Пташников Д.А., Топузов Э.Э. и др. Эпидемиология опухолей позвоночника у пациентов, получивших специализированную ортопедическую помощь Травматология и ортопедия России. 2019;25(1):104112.
Ивашкин В.Т., Шептулин А.А., Маев И.В. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению язвенной болезни Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016;26(6):4054.
Рудая Н.С., Жерлов Г.К. Хронические эрозии желудка: новые возможности патогенетического лечения // Экспериментальная и клиническая гастроэнтерология. 2009;№ 6:127131.
Dankert A, Duran G Engst-Hastreiter UFear of progression in patients with cancer, diabetes mellitus and chronic arthritis // Rehabilitation (Stuttg). 2003;42(3)155163. German. PubMed PMID: 12813652
Hessler C, Burkhardt T, Raimund F et al. Dynamics of neurological deficit after surgical decompression of symptomatic vertebral metastases Spine (Phila Pa 1976). 2009; 34:56671.
Ibrahim NK Sahin AA Dubrow RA Colitis associated with docetaxel-based chemotherapy in patients with metastatic breast cancer Lancet 2000;355(9200):281283.
Kim HJ Buchowski JM Moussallem CD Rose PS. Modern techniques in the treatment of patients with metastatic spine disease // J Bone Joint Surg Am. 2012;94(10)943951.
Leather HL Wingard JR. Infections following hematopoetic stem cell transplantation. Infections in the compromised host Inf. Dis. Clin. of N Am. 2001;15(2):487520.
Mandel GL. Principles and Practice of Infections Diseases. 16th ed. Elsevier Churchill Livingstone. 2010;4320 р.
Quan GM, Vital JM, Aurouer N et al. Surgery improves pain, function and quality of life in patients with spinal metastases: a prospective study on 118 patients Eur Spine J. 2011;20:19708.
Tomita K, Kawahara N, Kobayashi T et al. Surgical strategy for spinal metastases Spine (Phila Pa 1976). 2001;26:298306.
Wang CY Jermg JS Cheng KY. Pandrug-resistant Pseudomonas aeruginosa among hospitalized patients: clinical features, risk-factors and outcomes Clinical Microbiology and Infection. 2006;12:63–64.
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