[Simultant operative interventions for diseases of the colon and other abdominal organs].

In the clinic of general surgery, basing on surgical department No 2, for the 2012 - 2013 yrs period 469 patients were operated for the large bowel diseases (LBD). In 60 (12.8%) patients in LBD and concomitant diseases of abdominal cavity simultant operative interventions (SOI) were performed. Rate of postoperative complications have constituted 15%. All the patients are alive. Performance of SOI, not depending from duration and significant volume of the operative intervention, we consider optimal and feasible, because the complications rate in the patients did not differ trustworthy from such after a standard operative interventions.

[Experience of surgical treatment of patients with resistant and complicated forms of ulcerative colitis].

The feasibility and results of reconstructive and restorative interventions for resistant and complicated forms of ulcerative colitis. Timely establishing of indications for surgery, based on developed criteria, permit to increase the primary reconstructive interventions rate, that promote to improvement of the long-term results and social and occupational rehabilitation. The combination of radical and satisfactory functional results of surgery, we believe the most likely option in the reservoir ileoanal anastomosis formation without traumatizing the anal sphincter and the anorectal area transition. If not perform this operation in one or more stages the method of choice is coloproctectomy and ileostomy.

[Laparoscopic and NOTES endovideosurgical interventions for colonic diseases].

Peculiarities of learning period and results of endovideosurgical interventions in colonic diseases were analyzed. In 72 patients laparoscopic technology was applied, in 5-transanal endomicrosurgical (TEM) rectal resection for various colonic diseases, including 67 (87%)--for colorectal cancer. Complications have had occur in 9 (11.7%) patients. All the patients are alive. There was no need for formation of unloading or protective stoma. Performance of endovideosurgical operations in colon diseases is expedient because of their lesser traumaticity, reduction of a stationary treatment period and the need for diagnostic and treatment measures postoperatively.

[Multivariate analysis of risk factors of the anal functional disorders after abdominal-anal resection with delayed formation of colonic-anal anastomosis].

Multivariate analysis of clinical factors was conducted on the material histories of 195 patients treated between 2004 and 2006. In Donetsk regional antitumor center, which for rectal cancer (RC) is made abdomino-anal resection of the rectum with the delayed formation koloanal anastomosis after bringing down the colon to the perineum. In 97 patients the operation was performed with the use of electric welding soft tissue (EWST), in 98--a standard way. Studied the quality of life of patients using a questionnaire QLQ C30-CR38 and the function of the anal incontinence (Wexner scale). It is established, that the greatest influence on the function of the anal continence have a view of a combined and complex treatment, radicality intervention, the method of forming koloanal of anastomosis. Application EWST the second stage of surgery to cut off excess relegated intestine helped reduce the risk of poor function of the anal continence.

[Combined operative interventions for locally-spread diseases of large bowel].

In the clinic of general surgery, based on The Rural coloproctological centre, in 2012-2013 yrs 469 patients were operated for various diseases of large bowel. There were analyzed the results of treatment in 51 (10.8%) patients, to whom the combined operative interventions (COI) were conducted. For the large bowel tumors 48 (94.1%) patients were operated, for nontumoral diseases--3 (5.9%). COI, as a palliative procedures for the large bowel tumors of various localization, were performed in 22 (13.1%) patients, in 34 (67%)--with resection and excision of one organ, and in 17 (33%)--of two organs and more. In 49 (96%) patients the operation was completed by formation of interintestinal anastomosis or using colonic descendence. In adequate conduction of diagnostic measures and preoperative preparations of patients the COI performance is expedient, because it do not compromise the indices of the patients quality of life. For estimation of the COI risk grade it is necessary to take into account the volume and severity of each stage, expressiveness of the disorders in the organs and systems function as well as the tumors resectability.

[The method of mucosectomy of rectal stump in reconstructive surgery of ulcer colitis].

The method of coloproctectomy performance with formation of a J-like ileal reservoire and ileoanal anastomosis, using welding mucosectomy and protective ileostomy, was proposed. Application of the method guarantees complete excision of the rectal stump mucosa, what excludes the risk of the stump inflammation occurrence, as a sign of residual ulcer colitis in immediate and late postoperative period. Functional results in this setting are not worsen.

[Morphological changes of tissues in formation of a welding suture on the large intestine].

Abdominoanal resection with descending of left colon on perineum, leaving additional part of a descended intestine, was performed. For the hemorrhage arrest the welding sutures were put on intestinal wall. According to morphological investigations data, a damage of intestinal wall in the zone of a welding suture application is a reversible one, it spreads from the electrode branch on 2-3 mm. The presence of undamaged structures witnesses the presence of an active regeneration process in tissues around the welding suture.

[Application of endolymphatic therapy using catheterization of femoral lymphatic vessels in complex of treatment of oncological diseases]. / Primenenie éndolimfaticheskoi terapii putem kateterizatsii limfaticheskikh sosudov bedra v komplekse lecheniia onkologicheskikh zabolevanii.

Endolymphatic way of the medicinal preparations administration promotes their more effective influence on pathological focus. The experience of conduction of more then 15,000 of the lymphatic vessels catheterization manipulations was summarized, permitting to perform the treatment of patients successfully.

[Restoration of colonic continuity after the Hartmann's surgery]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle vypolneniia operatsii Gartmanna.

The intestinal continuity restoration after performance of Hartmann's operation in presence of long rectal stump was done using the method of the duplicature anastomosis formation, which was elaborated in the clinic. The frequency of postoperative complications occurrence was 9.8%: In presence of short rectal stump the colon was descended on perineum via submucosal tunnel in rectal stump according to the method, which was elaborated in the clinic. The frequency of the postoperative complications occurrence was 16.7%. The data presented trusts the expediency of application of the methods elaborated in the clinic for restoration of intestinal continuity after performance of Hartmann's operation in presence of long and short rectal stumps.

[The formation of the transplant for its descending to perineum with the sphincter-salvaging surgery in patients with disseminated sigmoid colon blood supply]. / Formirovanie transplantata dlia nizvedeniia na promezhnost' pri vypolnenii sfinktero-sokhraniaiushchei operatsii u bol'nykh s rassypnym tipom krovosnabzheniia sigmovidnoi obodochnoi kishki.

The methods of the transplant formation in the loose type of the sigmoyd colon blood supply and insufficiency of the over vessel, applied in patients during sphincter-preserving operation performance for cancer recti, was proposed. Satisfactory immediate and late follow up result was noted.

[Resection of rectum and bladder for cancer]. / Rezektsiia priamoi kishki i mochemogo puzyria po povodu raka.

In 1970-1997 period 43 patients with cancer recti, invading bladder, were operated on. The base of surgical tactics was performance of primarily-restorational operation as independent procedure and in the complex of treatment as well. There was noted the fair immediate and late follow-up result of treatment.

[The restoration of colonic continuity after Hartmann's operation]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle operatsii Gartmana.

The experience of restorational intervention with formation of duplicature (invagination) anastomosis after Hartmann's operation in 45 patients with complicated cancer recti and colonic cancer was summarized. Complications had occurred in 9.8% of observations, one patient died.

[Methods of inversion closure of transient colostomy]. / Sposob inversionnogo zakrytiia vremennoi kolostomy.

The method of inversive excision of colostomy, securing access to noninflamed tissues of intestine and pericolostomic region for consequent suturing made in accordance to requirements. While using the method purulent-inflammatory complications had occurred in less than 5% of patients and insufficiency of anastomotic sutures--in 3.4%.

[Contemporary aspects of treatment of colonic cancer, complicated by ileus. Part III. Treatment of rectal cancer, complicated by ileus]. / Sovremennye aspekty lecheniia raka tolstoikishki, oslozhnennogo neprokhodimost'iu kishechnika. Chast' III. Lechenie raka priamoi kishki, oslozhnennogo neprokhodimosti'iu kishechnika.

There were operated 331 patients with cancer of rectum, complicated by ileus. Radical operation was performed in 168 patients, palliative--in 57, symptomatic--in 106. Possibility of widening of evidences for performance of primary-restorational, sphincter-preservational operations was proved.

[Intensive therapy and strategy of management of patients with rectal cancer after the colonic descending to the perineum]. / Intensivnaia terapiia i taktika vedeniia bol'nykh rakov priamoi kishki posle nizvedeniia obodochnoi kishki na promezhnost'.

Optimal tactic for management of the patients on various stages of treatment was elaborated together with surgical procedure, basing on the experience of 3500 operations conduction for cancer recti, mainly abdominal resection with colon descendant to perineum. Methods of preoperative preparation and anesthesiological support were stated as well as the tactics of postoperative management of patients.