A NEW WAY OF ULTRA-LOW RESECTION OF THE RECTUM FOR RECTAL CANCER WITH THE FORMATION OF STAPLER ANASTOMOSIS ACCORDING TO THE TECHNOLOGY DEVELOPED IN THE CLINIC
DOI:
https://doi.org/10.32471/oncology.2663-7928.t-24-1-2022-g.10272Keywords:
anastomosis inconsistency, mobilization of the short stump, rectal cancer, ultra-low resectionAbstract
Aim: to improve the outputs of the rectal cancer surgical treatment by applying a developed in the clinic new method of ultra-low resection to remove tumors localizing in the middle- and lower ampullar rectal area. Object and methods: the developed method of ultra-low resection of the rectum for the rectal cancer was applied among other methods of its radical surgical treatment conducted for the period from 2005 to 2020 in 1832 patients. The resection of the rectum with primary anastomosis was made in 1422 patients, 309 of which were operations of ultra-low resections. The direct results of the treatment were studied by analyzing the frequency and nature of the emerging postoperative complications including the cases of anastomosis inconsistency. Results: introduction of ultra-low resections determined the decrease of extirpations from 24.0 to 13.6%. General number of post-operative complications during the researched period decreased from 15.5 to 14.1% due to a decrease of complications after ultra-low resections of the rectum from 15.4% to 12.6%. Colorectal anastomosis inconsistency after 784 low resections of the rectum (ultra-low resections accounted for 35.0%) appeared in 3.0% of cases which is significantly less than the number of anastomosis inconsistencies after low resections according to the data in the literature (10.0–15.0%). Conclusions: developed a new method of ultra-low resection for colorectal cancer of the middle and lower ampullary localization from the abdominal-intermediate access with the formation of nadanal stapler anastomosis, the possibility of creating which was provided by the original technology of lengthening the short rectum stump with its subsequent evagination on the perineum for examination and circular (annular) pication.
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