Kietov V. Optimization of surgical tretment of anal canal adenocarcinoma using sphinter saving technology

The object of the research is to review patients with the adenocarcinoma of the anal canal; the aim is to improve the immediate and long-term results of the anal canal adenocarcinoma treatment by introducing sphinctersaving methods of the operative intervention; research methods include clinical, questionnaire, laboratory, instrumental, morphological, statistic; the academic novelty and results - the prevalence of tumor in the anal canal and the morphological structure of adenocarcinomas have been studied for the first time on a large clinical material, direct and long-term results of different options for treating cancer of this localization have been found; in comparative aspects the frequency and the nature of intraoperative and postoperative complications have been discovered, and also the one, three- and five-year survival rate of patients have been studied, as well as the indicators of the rectal incontinence and the quality of life of patients with adenocarcinoma of the anal canal who also abdominal-perineal extirpation or abdominal-anal resection of the rectum have been gone through; for the first time it has been shown that the implementation of sphincter saving operations of the anal canal adenocarcinoma does not accompanied by increased incidence of perioperative complications, it also does not lead to a worsening of remote results of the treatment, and helps to reduce the frequency of postoperative complications and also allows to relieve patients from permanent colostomy, key-risk factors postoperative complications and the adverse delayed health effects of the treatment of adenocarcinomas of the anal canal have been identified, the practical feasibility of implementation of the primary recovery sphinctersaving operation has been proved, and the possibility of their usage in patients with damage obturator of the rectum has been demonstrated, indications and contraindications for using sphinctersaving operation with adenocarcinomas of the anal canal have been defined and justified; the abovementioned was introduced in the practical activity of "Municipal Inter-district Oncologic Dispensary" (city of Mariupol), "City Oncologic Dispensary" (city of Kramatorsk), "Regional Clinical Oncologic Dispensary" (city of Kharkiv), "Clinical Oncologic Dispensary" (city of Dnipro), as well as in the teaching process of Donetsk National Medical University named after M. Gorkiy; sphere of application - diagnostic and treatment process of oncologic and surgery departments, scientific and pedagogic processes of oncologic and surgery chairs of medical educational institutions.