[Is it possible to improve the quality of life of patients who have undergone pelvic evisceration?]. / Vozmozhno li uluchshenie kachestva zhizni bol'nykh pri évistseratsii taza?

Locally spread cancer makes up considerable percent (20-30%) in statistical structure of rectal tumors. In cases of cancer spread into the area of urine bladder triangle the operation of choice is pelvic evisceration. From 1977 to 1997 in the State research Centre of the Ministry of Health for Coloproctology pelvic evisceration in cancer spread to back wall of urine bladder in the area of triangle was carried out in 22 patients (20 male and 2 female). Mean age was 43.4 (29-56) years, 16 patients have undergone typical infralevator pelvic evisceration. There were no intraoperative lethality. Postoperative lethality made up 6.3%, complications--68.8%, 5-years survival rate--25%. Presence of two fecal fistulas on the anterior abdominal wall has decreased considerably the quality of life of the patients. Since 1993 the conception of preservation and restoration of natural passage of urine and bowel contents was adopted. In 4 cases infralevator pelvic evisceration with various types of ileocystoplasty and pull-through of colon into small pelvis with creation of smooth muscle cuff in perineal colostomy was carried out. In 2 patients evisceration was of supralevator-character cystoplasty of local tissues and performance of coloanal anastomosis were carried out. The application of reconstructive-restorative ways in coloproctology and urology considerably contributed to the improvement of the quality of life of the patients after pelvic evisceration.