[Total mesorectumectomy in surgical treatment of rectal cancer].

561 patients with rectal cancer were included in the study. The main group consisted of 119 patients, operated on during 2006-2009 years. They received total mesorectumectomy with the following pathomorphological control of the radicality. The group of control consisted of 442 patients, who had the rectum mobilized in a "standard" blunt fashion, without using principles of interfascial separation. The operation of total mesorectumectomy proved to take more time, though, it allowed to decrease the intraoperative blood loss, frequency of postoperative urogenital complications and did not increase rates of colorectal anastomosis insufficiency.

[Nerve-preserving operations in surgery of rectal cancer].

Forty-eight patients underwent surgery for rectal cancer. In all the patients total mesorectumectomy was combined with one of the types of nerves-preserving surgeries. Three groups were divided depending on types of this surgery: 1-- complete preservation of elements of autonomic nervous system (n=31), 2 -- partial preservation (n=16), 3 -- complete ablation (n=1). In 30 patients of group 1 normal urination recovered on postoperative day 2 to 4. In 2 patients of group 2 stable atony of urinary bladder was seen, and in 2 patients -- reflex ischuria. In patient of group 3 normal urination recovered on day 14 after surgery without vesical tenesmus. Long-term results were assessed in 1 to 12 months. No recurrences occurred. It is concluded that nerve-preserving surgeries improve functional results without loss of oncological radicalism.