OUTCOMES OF PLASTIC RESTORATION OF THE RECTUM EXCISED FOR CANCER

Zinchuk O.G., Kikot V.O., Sudnik Y.A., Sorokin B.V., Virun V.V., Pryjmak A.A., Pryjmak V.V., Kovalenko V.V., Zhybak I.I.

After abdominoperineal extirpation of the rectum (APER) for cancer, three approaches were applied in 75 patients to restore the colon instead of forming the colostomy in the abdominal wall. In the first group of 22 patients, posterior levator plastic operation was performed with the formation of a spiral smoothmuscular cuff (SC). In the second group of 29 post-APER patients with inadequate blood supply and impossibility to form SC, posterior levator plastic was performed with a perineal colostomy. In the third group of 24 patients, APER was performed according to a technique proposed by the authors. It included levator gluteoperineal plastic, life and functional results after restoration of the rectum, the results are comparable with that of abdominoperineal resection of the rectum with demucosation of the outgoing channel (performed in 34 patients). Comparison of the 2-year survival rates of the study patients and 410 patients after extirpation of there ctum with out its restorations howed that plastic restoration does not aggravate the tumor process. The proposed technique of plastic restoration of the rectum ensures a satisfactory quality of life and has advantages as compared to the standard Miles operation.