[Therapeutic policy in rectal cancer]

The results of clinical examination and treatment of 751 patients with rectal cancer are presented. A total of 684 (91.0%) patients underwent radical surgery. In 439 (64.2%) from them sphincter saving operations were carried out. The rate of sphincter saving procedures for the last 5 years has increased up to 73.8%, most often of them transbdominal resection was used--284 (64.7%) patients. Sygmoidorectal anastomosis in 158 (55.6%) patients was carried out by the hand sutures, and in 126 (44.4%)--suturing apparatuses were used. The operation was finished by the suture of the pelvic peritoneum by two layers of sutures and the drainage of the area of the anastomosis from the perineum site by two tubes for prevention of the development of peritonitis even in case of insufficiency of the anastomosis was made. All the operated patients underwent preoperative radiotherapy with a total dose 20-25 Gy. The basic stage of the operation was on demand followed by chemohyperthermic perfusion of the abdominal cavity. It was carried out in 30 patients, including 12 patients with rectal cancer. In cancer of the rectum of the II B and III stages the usage of chemotherapy is obligatory. New operations for metastases of cancer of the colon into the liver were made in 4 patients (left and extended right hemihepatectomy). Complications developed in 33.5% of patients, lethality made up 3.8%, including 1.8% for the last 5 years.