RESUMO
Results of performance of reconstructive-restoration operation in 7 patients with ascendostomy were analyzed. Of them in 4 as the first stage supraanal rectal resection was performed and in 3 - Gartmann operation. There was proposed the method for colonic continuity restoration after Gartmann operation performance, in which pancreatic stump is mobilized along its posterior wall, securing nutrient vessels up to highest point and lower surface of the pelvic peritoneum sheet. The pelvic peritoneal sheet is dissected from the peritoneal cavity side under guidance of surgeon hand and the rectoscope tube, introduced into rectal stump. During performance of second stage in all the patients massive adhesions were revealed. Postoperative complications were absent.
Assuntos
Colo Ascendente/cirurgia , Neoplasias do Colo/cirurgia , Colostomia/métodos , Procedimentos de Cirurgia Plástica/métodos , Adulto , Colo Ascendente/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Colonografia Tomográfica Computadorizada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Results of performance of reconstruction-restoration operations in 208 patients with one-barrel colostomy were analyzed. Earlier operation according to Hartmann procedure modification was performed in 138 (66.3% +/- 3.3%) of them, operation according to Hartmann--in 70 (33.7% +/- 3.3%). There were elaborated and introduced: the method of the intestinal continuity restoration, and also of the colonic anastomosis formation. The most frequent complications during performance of reconstructive operations were: deserosation of small intestine and colon, dissect of the hollow organ lumen, hemorrhage from the small pelvis veins. Cicatricial changes and adhesions in abdominal cavity and cavity of small pelvis were the main causes of the complications occurrence, making the intestinal loops and the colonic stump mobilization difficult, disordering the topographoanatomic arrangement of organs.