Krivorotko I. Preventive of anastomotic leakage after the combined operations for locally advanced rectal cancer (experimental-clinical research).

Dissertation is devoted to optimization of surgical treatment of patients with the locally advanced rectal cancer by improvement of methods of diagnostics and treatment of complications, introductions of the combined operations and methods of preventive of postoperative anastomotic leakage. The new experimental model of colon anastomosis has allowed to expand concept about the basic morphological and biochemical factors which lead to the postoperative anastomotic leakage. Retrospective and the prospective analysis of case histories of 385 patientes with a Т4 stage of rectal cancer from 1998 till 2007 is perfomed. As a result of research a new syndromes approach and algorithms of conservative and operative treatment of complications are developed. That was accompanied by decrease of anaesthesiologic risk in 79 % of patients, reduction of anastomotic leakage from 6,1 to 2,4 % and postoperative mortality from 6,0 to 4,9 %. New methods of the combined operations allowed to increase the radicality of surgical treatment and improve the early and late outcomes with satisfactory medical and social adaptation of patients after the resections of the adjacent organs.