The dissertation is dedicated to solving an urgent scientific and practical problem of modern surgery. Every year, more than 15 million people in the world suffer from cancer, and their number continues to grow (Fornaro R, Caratto M, Caratto E et al., 2016; Cheng Y., 2019; Sung H, Ferlay J, Siegel RL et al. 2021; ). Colorectal cancer occupies one of the leading places in the structure of malignant neoplasms (Ribeiro I.B., 2018; Foo C.C., 2019; Seo S.Y, Kim S.W., 2020).
According to the Bulletin of the National Cancer Registry of Ukraine, colorectal cancer incidence ranks first in the structure of cancer incidence and mortality in the adult population. According to the National Cancer Registry, colorectal cancer of the rectum ranks first in the structure of cancer incidence and mortality in the population of Ukraine ranks 6th in patients of both sexes, in men 6.10%, in women – 5.05%. Detection of stage I–II colorectal cancer in patients was noted in 54.7%, stage III of the disease – in 21.8%, stage IV was observed in 18.2%, colorectal cancer was not detected in 4.8% of cases.
In accordance with the set goal, the studies were aimed at increasing the effectiveness of prevention and treatment of patients with complicated forms of colorectal cancer by introducing microbiotic correction into a comprehensive surgical treatment approach.
Before conducting clinical and laboratory studies and further treatment of patients with colorectal cancer, in accordance with the study protocol, voluntary informed consent (in writing) was obtained from all patients to participate in the examination. Compliance with treatment and bioethics standards was confirmed by the Commission on Biotic Expertise and Ethics of Scientific Research at the O. O. Bogomolets National Medical University.
The object of the study was 411 patients with surgical diseases of colorectal cancer, who underwent surgical interventions. For our research work, 140 (100%) patients were included, of which 79 were women, 61 were men. The age of the patients ranged from 40 to 80 and more years, 1 male patient was aged 21 years, and 1 female patient was aged 39 years. This sample was formed for further analysis and research. Groups were formed. The control group is a retrospective analysis of the treatment of 80 patients who were operated on for urgent complications of colorectal cancer in the period from 2018 to 2021. An analysis of literature sources was conducted and an optimized algorithm for perioperative treatment of patients with acutely complicated colorectal cancer was developed based on the data obtained.
The main group is a prospective analysis of the treatment results of 60 patients (2022-2024) after the implementation of the developed perioperative treatment algorithm, who were prescribed personalized probiotic and antibacterial therapy based on the results of the study of the intestinal microbiota and the determination of the sensitivity of opportunistic microorganisms to antibiotics.
The first stage of the study (2021–2022) included a review and study of the literature, development of research methods, and clinical and laboratory examination of patients. The second stage of the study (2022–2024) included determination of the stage of colorectal cancer development. Determination of the effectiveness of the proposed general treatment methods. Generalization of the results obtained and writing individual sections of the dissertation. Writing individual sections of the dissertation. At the third stage (2024–2025), an analysis and evaluation of the results of the clinical study, design of the work, testing and submission of the dissertation for defense were carried out.
