RESUMEN
A method of forming the rectum reservoir after low anterior resection of the rectum has been developed, consisting in low anterior resection with mesorectumectomy, forming a reservoir from the colon, forming a rectosigmoid passage. The operation was made in 37 patients aged from 47 to 69 years for rectum cancer with the tumor localized in the middle and low ampular part. Complications in the early postoperative period appeared in 16.2% of the patients. There were no lethal outcomes. Mean time of staying at hospital after operation was 11.4 +/- 2.1 days. In the period from 3 to 5 years after operation the indices of fecal continence in patients of the main group and group of comparison (patients operated without forming the reservoir) by Wexner score were close to normal, making 4.6 +/- 0.4 and 3.1 +/- 0.5 scores.
Asunto(s)
Proctocolectomía Restauradora/métodos , Neoplasias del Recto/cirugía , Recto/cirugía , Anciano , Reservorios Cólicos/fisiología , Defecación/fisiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Técnicas de Sutura , Factores de Tiempo , Resultado del TratamientoRESUMEN
Original technologies of modeling of rectal ampulla and rectosigmoid sphincter mechanism have been developed for improvement of short- and long-term results after anterior resection of the rectum. The study group consisted of patients after upper resection (n=54) where rectosigmoid mechanism was formed as valve flap on 4-5 cm distally to anastomosis with recovery of pelvic peritoneum at this level, and of the patients after lower resection (n=47) where modeling of rectal ampulla and rectosigmoid mechanism was performed with serosomyotomy of intestinal portion between sphincter and anastomosis. The control group consisted of patients with direct anastomoses at the distance of 6-12 cm (n=12) and 5-1 cm from the anus. 4-6 months later the ampulla-shaped dilatation of intestinal portion after serosomyotomy and formation of functionally active sphincter mechanism were detected in patients of the study group. Developed technologies reduced the number of patients with multi-moment evacuation and incapable to hold the stool for 15 min.