Transanal Intubation for Preventing Colorectal Anastomotic Failure.

Introduction: Failure of low colorectal anastomosis remains challenging in surgical oncology, necessitating the exploration of new methods and improvements in existing preventive measures. Materials and Methods: This prospective study was conducted in two stages: intraluminal pressure in the colon was monitored in 32 patients by manometry and sonography over a 5-day postoperative period; 213 patients who underwent anterior resection of the rectum were analyzed, of whom 126 and 87 underwent diverting stoma (DS) and transanal intubation (TAI), respectively. Results: The effectiveness of the recommended technique for applying and removing transanal intubation (TAI) to prevent pneumo hydro strike (≥15 kPa) on the anastomosis line was analyzed in 87 patients and compared with imposed DS. TAI showed better borderline statistical significance (p = 0.051). The incidence of repeat surgery for anastomotic failure (AL) was seven (5.55%) and four (4.59%) in the DS and TAI groups, respectively. The distance of the anastomosis from the dentate line <60 mm was associated with a higher risk of AL occurrence (odds ratio (OR), 1.012; 95% confidence interval (CI), 1.007-1.017; p < 0.001; area under the curve (AUC) = 0.82). DS is recommended for men, as the risk of AL is significantly lower among women (OR, 0.41; 95% CI, 0.16-1.04; p = 0.062; AUC, 0.61; 95% CI, 0.54-0.67). Conclusions: Although TAI is advantageous over DS for preventing AL, surgeons select the method for the preventive approach based on the preoperative and intraoperative results.

A view on the problem of providing oncological aid during the war in Ukraine.

Introduction: Providing oncological care in conflict conditions is a difficult test for the country's health care system, especially if aggression is carried out in violation of the main international rules of conduct of war, the treaties of the Geneva Convention, when the aggressor attacks the civilian population. Material and methods: Having conducted an analysis of the style of military operations conducted by the aggressor and the peculiarities of the territories of Ukraine, the quality of providing oncological care before the conflict, the digital transformation of the state, the use of the application Diya by the population, and the functioning of the eHealth electronic medical telecommunication information system, we identified four zones of providing oncological care during martial law. Results: Each zone is defined and the amount of consultation and diagnostics with subsequent treatment assistance to the population is presented. Conclusions: Thanks to the practical implementation of the above characteristics, with a constantly functioning Internet network throughout Ukraine with a sufficiently high level of computer literacy of the population and available online means of communication, and in addition to the high level of organization of the Ukrainian and international volunteer service, it was possible to provide a qualified level of oncological care to the population during martial law.