A New Method of Colorectal Anastomosis Formation with Resection of the Rectum in the Experiment and Clinic

Abstract


Relevance Finding reliable methods is forming colorectal anastomosis actual problem of modern Coloproctology because the failure them reaches 69%. Development and application of compression-ligature methods is forming colorectal anastomosis, the most priority. Results of experimental and clinical studies have shown that compression-ligature suture is not traumatic, provides a high degree of reliability and hermetic through the compression effect, prevents infection in crosslinkable tissue, minimal inflammation and smooth wound healing anastomosis.

The purpose of the study The development, experimental and clinical approbation and the evaluation of the original method forming colorectal anastomosis on the transanal drainage.

Materials and methods The approbation of the developed method in the experiment performed on 20 white laboratory rats. The basis of the clinical section of the included 20 patients aged 41 to 74 years, with both tumor and non-tumor diseases of the colon and rectum, the operation which complete the formation of compression-ligature colorectal anastomosis on the transanal drainage.

Results and their discussion Full restoration of motility of the gastrointestinal tract occurred to 9 days after surgery. The intubation drainage and drainage of the abdominal cavity removed from 12 to14 days. Anastomosis failure and death was not. All patients discharged from the hospital from 15 to 22 days. At 30 days after surgery performed colonoscopy with polyfocal biopsy. The healing of anastomosis first intention in all cases. Histomorphological dissection of anastomosis in the experiment showed that in the anastomosis formed by our method, in all cases alterative and exudative phase of inflammation is minimal. By the fifth day after surgery identified process of regeneration, and by the tenth day identified process of scarring in all layers of the intestinal wall. With increasing periods of postoperative period marked the gradual formation of young connective tissue, other tissue replacement.

Conclusion The developed method allows you to create reliable compression colorectal anastomosis on the transanal drainage in limited pelvis space without regard to its anatomical features, diameters and wall thicknesses of bound segments intestine. The atraumatic of method and high impermeability of compression suture, as well as lack of foreign material in the lumen of the intestine after the removal of the intubation drainage ensures minimal inflammation in the tissue and smooth anastomosis healing.

 


Rostov regional Hospital, Rostov-on-Don, Russian Federation

Author for correspondence.
Email: coloproctolog_rostov@mail.ru
Head of the Coloproctological Department of the Center of reconstructive Surgery of the rostov regional Clinical Hospital

Rostov State Medical University, Rostov-on-Don, Russian Federation

Email: orph-rokb@yandex.ru
Candidate of Medicine, assistant Professor of the Department of Surgical Diseases № 4 of rostov State Medical University, Director of the Center of reconstructive Surgery of the rostov regional Clinical Hospital

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