RESUMEN
The article analyses experience in the treatment of 81 patients with diffuse polyposis who underwent subtotal resection of the colon with abdominoanal resection of the rectum and downward displacement of the right parts into the anal canal. It is shown that growth of the remaining occasional polyps and appearance of new polyps are encountered in the maintained parts of the colon and upper parts of the gastrointestinal tract in the postoperative period. The authors found that endoscopic polypectomy allows the right colon to be preserved in 92.6% of cases and the upper digestive tract in 97.5% of cases at a minimum risk of a surgical intervention.
Asunto(s)
Pólipos Intestinales/cirugía , Intestino Grueso , Adulto , Pólipos del Colon/cirugía , Endoscopía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Recurrencia , Factores de TiempoRESUMEN
Experience in treating 76 patients who were subjected to various sphincter-preserving operations is analysed. It is shown that after subtotal resection of the large intestine with ++abdomino-anal resection of the rectum and pull-through of the right parts of the colon into the anal canal as well as after pull-through of the segment of the transverse colon into the anal canal, the neuro-reflex activity of the musculus sphincter ani internus is destroyed in 55% and reduces in 25% of patients while the reflex activity of the musculus sphincter ani externus is disturbed in 45% of patients and is not restored later. The results bear evidence that the condition of the rectal obturation apparatus does not depend on the segment of the colon subjected to the pull-through operation (cecum, ascending colon, transverse colon). Experience has shown that the results of sphicterometry, electromyography, and electromanometry in various periods after colectomy, mucosectomy of the rectum, and formation of ileorectal anastomosis are much better than those after pull-through operations on various parts of the colon, and return to normal values in 18 months.
Asunto(s)
Canal Anal/fisiopatología , Colectomía/métodos , Pólipos del Colon/cirugía , Defecación/fisiología , Íleon/cirugía , Recto/cirugía , Reflejo/fisiología , Canal Anal/inervación , Anastomosis Quirúrgica/métodos , Pólipos del Colon/fisiopatología , Humanos , Factores de TiempoRESUMEN
The endoscopic sanitation is possible in patients operated upon for diffuse polyposis in cases of the absence of malignization of the polyps in the other parts of the colon. The endoscopic polypectomy performed on patients with diffuse polyposis allows preserving the rectum in 88.8% and the upper parts of the gastrointestinal tract in 99.1% of the cases.
Asunto(s)
Pólipos del Colon/cirugía , Neoplasias Primarias Múltiples/cirugía , Pólipos/cirugía , Neoplasias del Recto/cirugía , Adulto , Colectomía/métodos , Electrocirugia , Femenino , Humanos , Masculino , Recto/cirugíaAsunto(s)
Neoplasias Retroperitoneales/cirugía , Infección de la Herida Quirúrgica/prevención & control , Adulto , Clorhexidina/administración & dosificación , Humanos , Oxigenoterapia Hiperbárica , Cuidados Intraoperatorios , Persona de Mediana Edad , Lavado Peritoneal , Cuidados Posoperatorios , Cicatrización de HeridasRESUMEN
Primary multiple cancer of the colon was diagnosed in 116 out of 636 (18.2%) cases of diffuse polyposis of the organ. Cancer was more likely to develop in patients with proliferative forms of diffuse colonic polyposis (97.4%). Surgical procedure was determined by tumor site and extent of polyposis.
Asunto(s)
Pólipos del Colon/epidemiología , Neoplasias Intestinales/epidemiología , Intestino Grueso , Neoplasias Primarias Múltiples/epidemiología , Pólipos del Colon/cirugía , Femenino , Humanos , Neoplasias Intestinales/cirugía , Intestino Grueso/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/cirugíaRESUMEN
The article analyses the experience in the treatment of 49 patients with caudal teratomas for which reoperations had to be conducted. The operations were repeated because of diagnostic errors, inadequate surgical approach, and the development of intraoperative complications. Prolonged epidural anaesthesia with concurrent application of trimecaine hydrochloride and morphine was considered the most adequate type of anesthesia. In cases of fistulas draining the caudal teratomas into the rectum, the surgical tactics is determined by the location and size of the fistulas openings. To improve the results of treatment, all the coats of the teratoma must be removed and the cicatricially changed tissues excised, endolymphatic injection of antibiotics conducted, and the wound treated by the closed method.
Asunto(s)
Cauda Equina , Neoplasias del Sistema Nervioso Periférico/cirugía , Teratoma/cirugía , Adulto , Anestesia Epidural , Femenino , Humanos , Cuidados Posoperatorios , ReoperaciónRESUMEN
An analysis of results of examination and surgical treatment of 500 patients with diffuse polyposis coli for the recent 30 years has shown that one fourth of the patients have polyps in the stomach. They have structure of adenoma with different degree of epithelialdysplasia. The incidence of polyps and their structure do not change after operation on the colon. Carcinoma of the stomach in such patients can develop in 0,4% of the cases while the malignization index of colon polyps is 150 times higher. Hence, the conclusion is made of the first and foremost importance of operation on the colon.