2009-4

.: Дата публікації 2009-12-22 :: Переглядів: 9 :: :.

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SURGICAL METHOD CHOICE FOR FAMILIAL ADENOMATOUS POLYPOSIS TREATMENT
A.I. Poyda, V.M. Melnik

The aim – to improve the surgical treatment results in patients with familial adenomatous polyposis.

Materials and methods. Surgical treatment tactics was developed and used in 16 patients with familial adenomatous polyposis. Tactics provides timely disease diagnostics, radical operation performance – colectomy with extremely low anterior rectum resection, mucosectomy to the dentate line, small-intestine reservoir formation, its disposition in a small pelvis cavity and ileoanal anastomose, protection of the created small-intestine reservoir and ileoanal anastomose constraction, prophylaxis of postoperative complications, an estimation the results of treatment.

Results and discussion. The postoperative complications caused by formed reservoir and ileoanal anastomose healing were in 3 (18.7 %) patients. Satisfactory functional results were received. Frequency of occurrence and degree of expressiveness of the pathological syndromes, caused by colectomy with extremely low anterior resection of rectum, formation small-intestine reservoir, ileoendoanal anastomose, in particular diarrhea and postcolectomy syndromes, the secondary anal incontinence syndrome, is considerably reduced.

Conclusions. In familial adenomatous polyposis treatment it should give preference to radical, initially-restorative operations. The operation choice is colectomy with extremely low anterior rectum resection, mucosectomy to the dentate line, formation a small-intestine reservoir and ileoendoanal anastomose. Developing the reconstructive-restorative operations after colectomy with extremely low anterior resection of rectum, mucosectomy to the dentate line, namely the new type of small-intestine reservoir and ileoendoanal anastomose, prophylaxis of complications of its healing promoted reduction of that complications to 1 (16.7 %).