Выбор тактики комбинированного лечения пациентов со злокачественными онкозаболеваниями толстой кишки

Abstract

The aim. To determine the definition of nutritional extinction and its characteristics in various phases of carcinogenesis, to show the role of nutritional counseling in the selection of personalized metabolic correction programs. Materials and methods. 107 patients with pancreatic head adenocarcinoma (T3 and T4). In addition to traditional methods, the nutritional status was assessed according to the parameters of the well-known personalized alimentary-volemic diagnosis and the main common metabolic syndromes (inflammatory, hypermetabolism-hypercatabolism, toxic-anemic, anorexia-cachexia). Results. The phases of nutritional extinction are identified, in accordance with which the original schemes of metabolic correction are developed. The effectiveness of the programs used, calculated according to the degree of well-being, was significantly higher in comparison with standard solutions. The feasibility of using this tactic was confirmed (in addition to traditional tests) by measuring the metabolism in lysosomes (according to the analysis of the level of cathepsin L using ELISA in the blood serum of the considered groups of patients). Conclusions. 1) When determining the tactics of nutritional treatment of cancer patients, it is advisable to distinguish the phases of nutritional extinction, on the basis of which to carry out a differentiated metabolic correction. 2) The role of nutritional counseling (along with consulting with a surgeon and an anesthesiologist) allows you to clarify the strategy of treatment of patients with oncological pathology, and in some cases, make adjustments to the choice of the nature of the surgical aid.