RESUMO
Proctectomy with total mesorectumectomy, resection of the interior sphincter, deep parts of the external sphincter and bringing down were fulfilled according to an original authors' method in 7 patients aged from 38 to 78 years for cancer of the inferioampular part of the rectum with tumor located within the limits 8-35 mm from the anus (T3N1MO (n=1), T3NOM1 (n=1), T4N2M1 (n=1). Six months after operation conscious urge to defecation 1-2 times a day and containment of stools were noted and a year later it was possible to ignore urges during 15-30 min. In 5 patients T3NOM0--T3N1M0 relapse-free period for 3-5 years was noted.
Assuntos
Canal Anal/cirurgia , Colectomia/métodos , Procedimentos de Cirurgia Plástica/métodos , Neoplasias Retais/cirurgia , Reto/cirurgia , Adulto , Idoso , Canal Anal/fisiopatologia , Animais , Defecação , Modelos Animais de Doenças , Cães , Seguimentos , Humanos , Pessoa de Meia-Idade , Neoplasias Retais/fisiopatologia , Reto/fisiopatologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Endoscopic ultrasonic examination for diagnosis of malignant tumors of a lower-ampullar part of the rectum determined indications to inter-sphincter resection consisting in total mesorectumectomy, resection of the rectum and internal sphincter. The method of creation of a globe-shape reservoir with artificial muscular sphincter was developed. Fourteen patients underwent surgery, the follow-up was up to 3,5 years. It is demonstrated that a globe-shape extensible reservoir and autonomic bloching function of muscular sphincter are the main conditions of repair of defecation functions in long-term period after inter-sphincter resection.