[SIDE-TO-END ANASTOMOSIS IN LOW ANTERIOR RECTAL RESECTION].

The authors have launched a prospective randomized study aimed to make a comparison of functional results of formation of straight coloanal (control group) and side-to end (main group) anastomosis in case of low anterior rectal resection since 2012. Each group consisted of 40 patients undergoing operation concerning uncomplicated rectal cancer of medium-ampullar section of rectum. It was noted that patients of the main group had lower stool frequency in postoperative period. A function of the interior sphincter was less damaged and the rate of compliance of rectum was high.

[Proctectomy with external sphincter preservation: long-term functional results].

52 patients with the lower ampullary rectal cancer with tumor localization on the dentate line level had been operated with the use of the originally developed reconstructive technique, permitting preservation of the external anal sphincter elements and, consequently, partial continence. Colonic rectal pouch and smooth muscle cuff were performed during the neorectum and neoanus plasty. A protective stoma was performed in all cases. Contractive activity of saved elements of EAS improved with a course of time and squeezing anal pressure increased as well. Consequent continence improvement occurred during the first year after the stoma closure, biofeed-back therapy provided faster rehabilitation. The achieved long-term functional results (73,4% actuarial 5-year disease-free survival) prove the oncological efficacy of the method on the strict assumption of indications observance. Thus, proctectomy with partial external anal sphincter preservation allows to avoid permanent colostomy and provides a satisfactory quality of life of the operated patients.

[Proctectomy with external sphincter elements' preservation in surgery of low-ampullary rectal cancer].

Operational technique for the rectum tumors, localized at the level of dentate line, developed in the State center of coloproctology, allows preservation of external anal sphincter elements and thus, partial preservation of defecation control. Technique is described and proved, preliminary treatment results of 42 patients are analysed. The operation is oncologically effective (local recurrence rate 4,8%). Preservation of external sphincter elements has a high functional value in complex with "neorectum" and "neosphincter". A majority of operated patients can keep the stool, 80% of able-bodied patients continued their professional activities.