[Transanal endoscopic rectal resection: immediate and long-term results]. / Transanal'naya endoskopicheskaya rezektsiya pryamoi kishki: neposredstvennye i otdalennye rezul'taty.

OBJECTIVE: To analyze the results of transanal endoscopic microsurgery in patients with rectal tumors. MATERIAL AND METHODS: We analyzed 87 transanal endoscopic resections of rectal benign tumors (35 patients) and rectal cancer cT1N0M0 (52 patients) for the period since 2012. RESULTS: There were 2 (3.8%) intraoperative intestinal wall perforations into abdominal cavity and 2 (3.8%) postoperative bleedings among patients with rectal cancer. Four (7.7%) patients developed recurrent rectal cancer (pT1N0M0 - 1 patient, pT2N0M0 - 3 patients; by tumor grades: G1 - 2 patients, G2 - 2 patients) within 1.6-5.2 years. All recurrent tumors were located on anterior rectal wall. In patients with rectal cancer, cumulative relapse-free survival was 0.923 (standard error 0.037), cumulative overall survival - 0.926 (standard error 0.043). There was 1 (4.3%) intraoperative intestinal wall perforation among patients with benign rectal tumors. Postoperative anastomotic leakage occurred in 1 (4.3%) patient. Recurrent benign tumors occurred in 2 (8.7%) patients with villous rectal tumors. No relapses were observed in patients with rectal adenomas (p=1.0). CONCLUSION: Transanal endoscopic rectal resection is effective for benign rectal tumors and rectal cancer pT1N0M0 with high relapse-free and overall survival and low complication rate. Risk factors of recurrence are tumor stage pT2N0M0, tumor location on anterior wall and distance from the anus over 10 cm.

Familial adenomatosis of the colon: current state of the problem.

AIM: The urgency of the problem of familial adenomatosis of the colon (FAC) is caused both by the severity of the disease with the inevitable development of cancer without timely treatment, and the involvement of the patient's blood relatives in this problem. Due to the rare inci- dence of this disease, many issues require discussion. To determine the possibility of timely treatment of FAC patients maintaining a satisfactory quality of life. MATERIALS AND METHODS: The data on 5 FAC patients and 12 their blood relatives were studied. Clinical, endoscopic and genetic characteristics of the disease and treatment were analyzed. Results. Demonstrated that family history, genetic and endoscopic examinations allow diagnosis of FAC. Colectomy with rectal resection and the creation of a small intestine reservoir with reservoir-rectal anastomosis provide a sufficient quality of life for patients. Examination of the patient's blood relatives reveals new patients requiring additional examination and treatment. CONCLUSION: The problem of FAC is multidisciplinary and involves therapists, gastroenterologists, pediatricians, geneticists, endoscopists, radi- ologists, surgeons and oncologists. Only a timely diagnosis can help the patient to undergo radical treatment before the development of colon cancer.