New method of ileotransverse anastomosis formation as a procedure of compensatory changes improvement
Summary. Carrying out drastic operative interventions on the right half of the colon is conventionally accompanied by a number of unfavorable consequences which substantially aggravate the patients’ life quality. Aim of the research — to improve the results of the surgical treatment of the patients with cancer of the right half of the colon by means of the development of adequate invaginated longitudinal terminal-lateral ileotransverse anastomosis. The authors suggest the method of invaginated terminal-lateral ileotransverse anastomosis formation when performing right hemicolectomy which lies in that mesenteric border of the terminal portion of the ileum, cut at an angle, adjoins to transverse-colon in aboral direction at an angle of 45°, and antimesenteric one — to the stump of transverse-colon in oral direction. Small intestine is crossed at an angle of 45° till mesenteric border with further introduction and fixation of the latter in the lumen of the transverse colon at an acute angle (pat. № 85715 dated 25 October, 2013). Mechanic reliability of anastomosis and its antireflex properties were investigated in experiment. Anatomical-functional properties of anastomosis, patients’ life quality after the operation as well as physical, chemical and microscopic properties of feces were studied in clinics. The suggested terminal-lateral longitudinal invagenated ileotransverse anastomosis enables, comparatively quicker and safely, to restore gastrointestinal tract patency, renewing, in addition to that, closing function of ileocecal valve that improves the course of compensatory processes and formation of compensatory changes after the fulfillment of the right hemicolectomy as well. Application of the propound ileotransverse anastomosis at carrying out the right hemicolectomy in patients with cancer of the right half of the colon leads to the improvement of the patient’ life quality with positive dynamics during one year after the operation. Coprogramme of the patients, whom the suggested ileotransverse anastomosis was formed to, is characterized by solid shaped stool, reliable prevalence of the persons’ per cent, in whom invariable muscular fibers, vegetable cellular tissue, digested and indigested, intracellular and extracellular starch, neutral fat, fatty acids, soap, mucus, leucocytes have not been revealed, and also, by complete absence of the latter ones in great quantity during the whole term of the research. Thus, formation of the suggested ileotransverse anastomosis, when carrying out right hemicolectomy, enables the results of the treatment of patients with cancer of the right half of the colon and their post-discharge adjustment to become better.
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