Abstract and keywords
Abstract (English):
The aim: to study the features of perforative gastroduodenal ulcer (PGDU) in cancer patients. Materials and methods: a retrospective study of the postoperative results of surgical treatment of PGDU in 45 patients with malignant tumors in VRCOD. Comorbidity was assessed on the basis of Charlson-Deyo scale. Paired, multiple linear and binary logistic regression was used to predict the duration and outcome of treatment. Results: 45 patients were included into the analysis: 25 (55.6 %) men and 20 (44.4 %) women. The median age was 54 years (Q1-Q3 = 46-67). Ulcer history is noted in 25 (55.6 %) observations. Combined complications were met in 4 (8.9 %) cases. The most common localization of PGDU was the front wall of the bulb of the duodenum - 17 (37.8 %). The presence of cancer caused the minimum Charlson-Deyo index 2, and in 13 (28.9 %) cases of metastatic cancer - 6. Suturing of the ulcer prevailed in 36 cases (80 %). In other observations we performed: stomach resection - 5 (11.1 %), vagotomy with pyloroplasty - 1 (2.2 %), suturing of the ulcer from the minilaparotomy - 2 (4.5 %), laparoscopic suturing of the ulcer - 1 (2.2 %). The median duration of the operation at PGD was 80 (Q1-Q3=70-95) minutes. The duration of the postoperative period was on average 10 days (IQR9-14 days). The mortality rate was 15.6 % (7/45). Patients with Charlson-Deyo comorbidity index above 3 had a higher risk of postoperative complications (p=0,005) and death (p=0,039). During the univariate analysis general surgical and comorbidity factors affecting postoperative mortality were revealed: age (p=0,01), perforation duration of more than 24 hours (p<0,001), Boey index 2-3 (p=0,005), Mannheim peritonitis index more than 29 (p<0,001), the number of chemotherapy courses performed (p=0,006) and the Charlson-Deyo index more than 3 (p=0,05). In multivariate analysis - age (p=0,028) and the number of chemotherapy courses conducted (p=0,008).

perforative gastroduodenal ulcer, predictive model, cancer patients
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