ANASTOMOSIS FORMATION METHOD AFTER COLECTOMY OF ULTRA-LOW ANTERIOR RECTUM RESECTION AND SURGICAL ANAL CANAL MUCOSECTOMY

Goals. Improving the results of reconstructive operations after colectomy, ultra-low anterior rectum resection, and surgical anal canal mucosectomy by mending of formation ileoendoanal anastomosis technique. Methods. Colectomy, ultra-low anterior rectum resec-tion, surgical anal canal mucosectomy are radical stages in the surgical treatment of ulcerative colitis, familial adenomatous polyposis, Crohn's disease of the colon in cases of total lesion. Reconstructive stage of surgical treatment was pelvic intestinal reservoir formation, ileoendoanal anastomosis of protruding loopback ileostomy. Clinical methods, anoscopy, radiography ileaendoanal anastomosis area were used in research of features of healing of ileaendoanal anastomosis that has been designed. The function of anal retention was discovered by questioning, anal sphincterometry with Pro Medico sphincterometer. Research results. Postoperative complications arose in seven (21.7%) operated patients. Among these, intestinal-vaginal fistula - in 1 patient, abscess of the abdominal cavity - in 1, suppuration of an operational wound - in 2, pyelocystitis - in 2, pneumonia - 1. There were no cases of postoperative lethality. In the first days after the "closure" of the defining ile-ostomy, most patients had a disturbance of anal retention. After 3 months and later, an urge to empty was formed, the ability to differentiate the components of the intestinal contents was re-stored, and the index of anal retention improved. These indicators approached the physiological one year after the closure of the protective ileostomy. During this period, the tone of the internal sphincter of the rectum was 41.1 ± 7.4, the external sphincter of the rectum was 79.1 ± 7.5 (mm Hg). Conclusions: 1. Developed methods aimed at improving the technical aspects of the formation of ileoendoanal anastomosis: mucosectomy, dislocation of the small intestine transplant into the pelvic cavity, the formation of ileoendoanal anastomosis are sufficiently substantiated, differ in the simplicity of the technique of formation, with a negligible risk of postoperative com-plications. 2. The use of developed methods for improving the formation of ileoendoanal anastomosis in 32 patients contributed to the reduction of the incidence of postoperative complications, improvement of functional results after the colectomy, ultra-low anterior rectum resection, and surgical anal canal mucosectomy.