Aim. To analyse and generalize available literature data on the problem of colorectal anastomotic leakage after rectal resection. Key findings. Over the last decade, there has been an increasing trend towards sphincter-preserving operations in modern colorectal surgery. The widespread use of suturing devices of various diameters allows the formation of ultra-low anastomoses (at the level of the pelvic floor). One of the menacing complications after rectal resection is anastomotic leakage, which frequency can reach 21%. The mortality from anastomotic leakage can reach 40%. The analysed literature sources discuss a variety of risk factors, both preoperative and intraoperative, affecting the healing of the inter-intestinal anastomosis. In almost all studies, the height of the tumour and the anastomosis from the anus, preoperative radiotherapy and male sex are independent risk factors for the development of colorectal anastomotic leakage. Concerning other factors, there are conflicting opinions. The timely use of preventive measures and early diagnosis of colorectal anastomotic leakage can reduce the number and severity of postoperative complications.Conclusion. Individual consideration of risk factors and their adequate assessment in terms of possible complications are decisive in the choice of the extent of surgical intervention, which will undoubtedly improve the immediate and long-term results of the surgical treatment of colorectal cancer.
Purpose of research. Evaluation of direct results of surgical treatment of patients with cancer localization in the middle and lower ampullary rectum using laparoscopic and open methods. Materials and methods: a retrospective analysis was performed on 221 patients who underwent anterior and low anterior rectal resection. Results. Independent risk factors for failure of low colorectal anastomosis were determined. Laparoscopic treatment of rectal cancer with total mesorectumectomy does not lead to an increase in the number of intra—and postoperative complications. Laparoscopic mesorectumectomy is a priority method in comparison with the open method of operation.
на втором визите и до 0,9 балла к моменту окончания наблюдения. Статистически значимая (р < 0,05) положительная динамика прослеживалась в отношении всех оцениваемых симптомов (боль в животе, запор, диарея, метеоризм, тенезмы). К окончанию наблюдения 59,6 % пациентов и 68,8 % врачей оценили результаты лечения как «отличные», 25,2 % пациентов и 20,4 % врачей-как «хорошие». Выводы. За время наблюдения отмечалось значительное уменьшение выраженности симптомов заболевания: боли в животе, запора, диареи, метеоризма, тенезмов. Не было зарегистрировано НЯ, связанных с приемом рифаксимина-α. Полученные данные подтверждают ранее опубликованные результаты рандомизированных контролируемых исследований по эффективности и безопасности рифаксимина-α при неосложненной дивертикулярной болезни. Ключевые слова: дивертикулярная болезнь, рифаксимин-α, неинтервенционное исследование Конфликт интересов: Исследование спонсировано компанией ООО «Альфасигма Рус». Благодарности: Авторы выражают благодарность контрактно-исследовательской организации «Лиганд ресерч» (Москва) за организацию исследования, представителям компании ООО «Альфасигма Рус» за спонсорскую и методологическую поддержку исследования.
AIM. to evaluate results of anterior (AR) and low anterior resection (LAR) for rectal carcinoma with stapler anastomosis. MATERIALS AND METHODS. 114 patients aged from 33 to 84 years were included into study. Of them 60 patients had low anterior rectal resection. RESULTS. Anastomotic leakage developed in 7 (6,1 %) cases (5 (8,3 %) 5 after LAR and 2 (3,7 %) after AR) between POD 3 and 7 days (р<0,05). CONCLUSION. Mechanical preparation of the colon, precise techniques of mobilization of the rectum and mesorectum, prevention of tension on suture line, compliance with the application techniques of mechanical anastomosis, control of its integrity, considering of risk factors allow to produce a secure suture and are important in prevention of anastomosis leakage.
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