[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.

[Diagnosis and surgical treatment of recurrences of rectal cancer]. / Diagnosotika i khirurgicheskoe lechenie retsidivov raka priamoi kishki.

The authors present the analysis of the results of surgical treatment of 145 patients with recurrent rectal carcinoma in 1960-1990 at the State Scientific Centre of Proctology. A group of 304 patients who underwent radical operation for carcinoma of the rectum was also studied to determine the frequency of recurrences after radical surgery. It was found to be 30.9% (in 94 out of 304 patients). More than half of carcinoma recurrences (63.8%) were revealed in the first postoperative year and 85.1% in the first two years. The average term of their appearance was 13.4 months. A radical operation may be performed for a second time in only 22.3% of cases of recurrences. The study of factors considerably influencing the frequency of the recurrence made it possible to determine three groups of patients with various risks of the development and create a scheme of their regular medical examination. Repeated radical operations on the cavities were carried out in 90 patients with recurrences, in 55 patients local resection of recurrrent tumor was performed. The indications for repeated operations were elaborated. More than half repeated operations on the cavity (53.3%) were combined, extensive, and concomitant. The incidence of intraoperative (52.2%) and postoperative (62.2%) complications was significantly higher than in primary operations. The use of a complex of therapeutic and preventive measures usulted in relatively low postoperative lethality (6.7%). Five-year survival after repeated operations on the cavity was 29 +/- 5.5%, the frequency of repeated recurrences was 34.5 +/- 5.2%; the respective figures after local excision were 14.6 +/- 5.5 and 40.8 +/- 7%.

[The groups at risk for a recurrence of rectal cancer after radical operations]. / Gruppy riska retsidiva raka priamoi kishki posle radikal'nykh operatsii.

The article discusses a group of patients with rectal carcinoma who underwent radical operations at the Scientific Research Institute of Proctology in 1982-1983. The terms and frequency of rectal carcinoma recurrences are analysed and the factors influencing these indices are studied. The results made it possible to form a group with a risk of a recurrence among patients with carcinoma of the rectum and suggest new schedules of regular medical observation over these patients with consideration for the risk group.

[A comparative evaluation of methods for diagnosing recurrence of rectal cancer after radical surgery]. / Sravnitel'naia otsenka metodov diagnostiki retsidivov raka priamoi kishki posle radikal'nykh operatsii.

As a result of a study of 173 cases of rectal cancer, applicability of bleomycin-111indium for diagnosis of tumor recurrences was shown. Assays of carcinoembryonic antigen (CEA) as a separate diagnostic procedure proved inadequate due to their low sensitivity (42.1%). Since the effectiveness of ultrasonography application in diagnosing rectal cancer was as high as 91%, it should be recommended for follow-up of radically operated patients.

[Combined treatment of rectal cancer]. / Kombinirovannoe lechenie raka priamoi kishki.

The comparative analysis of two methods of treatment (a combined method with the preoperative radiotherapy and a purely surgical one) of 363 patients with carcinoma of the rectum has shown that an intensive concentrated course of radiotherapy with irradiation of extended fields (the irradiation zone includes the small pelvis cavity and paraaortal lymph nodes up to the level of the second lumbar vertebra) is satisfactorily endured by the patients and does not complicate the operation. In the postoperative period the patients subjected to preoperative radiotherapy showed a longer healing of the perineal wound. The authors failed to reveal any difference in the results of a 3-year survival of the patients after the combined and purely surgical methods of treatment. Local recurrencies were found to be less frequent following the combined method.

[Metastatic ovarian tumors in rectal cancer patients]. / Metastaticheskie opukholi iaichnikov u bol'nykh rakom priamoi kishki.

Under investigation were 207 female patients with carcinoma of the rectum aged 17 to 68 subjected to bilateral ovariectomy in addition to radical operation. A control group (95 women) subjected only to radical operations for carcinoma of the rectum was also analyzed. It was found that the metastatic spreading of the rectum carcinoma into the ovaries took place in 8.2% of cases. The ovaries were established to be involved in patients with a considerable spread of the primary tumor (T3-T4) growing through all the layers of the intestine wall (P4) disposed superior to the pelvic peritoneum. The metastatic spreading into the ovaries was most frequently observed in women in the postmenopausal period. The data obtained suggest the implantation to be the most probable way of the involvement of the ovaries.