Melnik V. Recontructive-restorative surgery after removing functional active parts of the large bowel.

A thesis submitted on competition of the scientific degree of the doctor of medical science on a speciality 14.01.03. - Surgery. National medical university named by O. Bogomolets. Ministry of Health of Ukraine. - Kyiv, 2008. This research work is dedicated to solution of actual problem of modern coloproctology - the improvement of results and life quality for the patients who underwent surgery with removing functional active parts of the large bowel: ileocecal part, colon, rectal ampule and sphincters. New types of creation of the ileal and colonic anatomic-functional reservoirs after colectomy, colectomy and anterior resection or extirpation of the rectum, anterior resection and extirpation of the rectum depending on anatomic interrelations between parts of ileum and rectum, colon and rectum were proposed as well as sphincter-saving surgery for distal rectal cancer, methods of intestinal suturing, ways of prophylaxis and treatment anastomotic and reservoir complications. The results of new recontructive-restorative operations in 132 patients were compared with 135 patients who underwent traditional surgery. The advantage of new methods were demonstrated in decreasing the number of patients with reflux-ileitis, postcolectomy syndrome, low anterior resection syndrome, anal incontinence, indefinite ileo- or colostomy, postoperative anastomotic and reservoir complications, postoperative lethality; significant improvement of functional outcomes, life quality and social rehabilitation of patients.