LONG-TERM RESULTS OF PROCTECTOMY WITH THE RECONSTRUCTION OF THE SPHINCTER, LEVATOR AND RESERVES-STORAGE TANK WITH LOW RECTAL CANCER
https://doi.org/10.20538/1682-0363-2014-5-5-11
Abstract
Proctectomy with total mesorectal excision, resection of the internal sphincter, deep portions of the external sphincter and reductionwas performed on nine patients aged from 38 to 74 years with adenocarcinoma of low rectal cancer (T2N0M0 (n = 4), T2N1M0 (n = 1), T3N0M1 (n = 3), T4N2M1 (n = 1)), located in 8–25 mm from an anus. Simultaneously, atypical resections of the liver were performed on two of the patients. In the perineal section of the reduced intestine a sphincter was created from a smooth muscle cuff, a levator from not free serous, and a muscular flap, fixed to a forward wall of the small basin, and a reservoir of cross stitched submucosa site formed after the formation of a levator.
5 of the patients (T2N0-1M0)had no disease advance 3–9 years. They were able to hold firm feces, but were less able to hold liquid feces, and sometimes didn’t hold intestinal gas or differentiate between feces and gas, but were capable of ignoring an urge to defecate and to detain a defecation (level of a fecal continence on a scale of "Wexner score" (11 ± 1) of points).
About the Authors
S. R. Bashirov
Siberian State Medical University, Tomsk
Russian Federation
Russian Federation
M. N. Trifonov
Siberian State Medical University, Tomsk;
Branch no. 7 “1602 the District Military Clinical Hospital” the Ministry of Defense of the Russian Federation, Maykop
Russian Federation
Russian Federation
V. I. Tikhonov
Siberian State Medical University, Tomsk
Russian Federation
Russian Federation
M. Yu. Grishchenko
Siberian State Medical University, Tomsk
Russian Federation
Russian Federation
References
1. Prorokov V.V., Vlasov O.A. Centuries strategy for the treatment of colorectal cancer. Khirurgiya – Surgery, 2013, no. 6, pp. 92–95.
2. Zherlov G.K., Bashirov S.R. Reservoir and sphincterotomies technologies in surgery for rectal cancer. Novosibirsk, Sci-ence Publ., 2008. 184 p. (in Russian).
3. Vorobiev G.I., Shelygin Yu.A., Pikunov D.Yu. et al. Remote functional results of proctectomy to the preservation of on-outer sphincter. Khirurgiya – Surgery, 2009, no. 10, pp. 4–9.
4. Andreyev A.V. Comparative evaluation of the quality of life of patients undergoing koloto-marousia and sphincteroplasty operations on the rectum. Dis. Cand. med. sci. Novosibirsk, 2010. 24 p. (in Russian).
5. Hida J., Yasutomi M., Maruyama T. et al. Enlargement of colonic pouch after proctectomy and coloanal anastomosis: potential cause for evacuation difficulty. Diseases of the Colon & Rectum, 1999, vol. 42, pp. 1181–1188.
6. Hida J., Yasutomi M., Maruyama T. et al. Horizontal incli-nation of the longitudinal axis of the colonic J-pouch: defining causes of evacuation difficulty. Diseases of the Colon & Rectum, 1999, vol. 42, pp. 1560–1568.
7. Tsarkov P.V. et al. Method of formation of smooth muscle newsfilter after resection or removal of the switching appa-ratus of the rectum. Onkokhirurgiya – Oncosurgery, 2008, no. 1, p. 30.
8. Bashirov S.R., Bashirov R.S., Trifonov M.N. et al. The patent for the invention no. 2383306, IPC AV/00. Method of formation of levator on relegated intestine when resection of the rectum c uninstalling different portions on-outer sphincter. No. 2009113075; Appl. 07.04.2009; publ. 10.03.2010; Bulletin no. 7. (in Russian).
Review
For citations:
Bashirov S.R., Trifonov M.N., Tikhonov V.I., Grishchenko M.Yu. LONG-TERM RESULTS OF PROCTECTOMY WITH THE RECONSTRUCTION OF THE SPHINCTER, LEVATOR AND RESERVES-STORAGE TANK WITH LOW RECTAL CANCER. Bulletin of Siberian Medicine. 2014;13(5):5-11. (In Russ.) https://doi.org/10.20538/1682-0363-2014-5-5-11
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